Research On Classification And Clinical Features Of Outpatients With Headache

【Objective】This study using self-administered questionnaires, to explore the types of neurology outpatients with headache in order to identify patients with headache treatment situation, and compare the clinical characteristics of different types of headache, which offer a reference to theresearch of clinical diagnosis, treatment and prevention ofheadache.【Methods】A period of four months cross-sectional survey was conducted for patients with the chief complaint of headache at the First Affiliated Hospital of Xiamen University neurology clinic. Face to face interviews were carried out continuously and the information was collected by self-administered questionnaires. Cases of the outpatients with headache were diagnosed according to the International Classification of Headache Disorders,3rd edition(beta version) and diagnosed by neurology specialist. Data was analyzed by SPSS software.【Results】A total of 6884 outpatients participated in the study from February 2014 to June 2014, and 1372(19.93%) outpatients with the chief complaint of headache. 1163 patients were interviewed, the male and female ratio was 1: 2.2 and the average age was(43.2 ± 14.1) years old. 516 cases of primary headache(44.4%) and 321 cases of secondary headache(27.6%) were defined. There were 241(20.7%) tension-type headache(TTH) and 232(20.0%) migraine. The ratio of male to female in migraine was 1:5.1 and the ratio of male to female in tension-type headache was 1:2.7. The average age of onset of migraine was(27.1 + 10.5) years old and the average age of onset of tension type headache was(36.6 + 13.2) years old. Most patients with migraine and TTH were middle and low income earners. And migraineurs went into higher education than TTH. Seen from their occupation, patients with migraine were mainly rank-and-file employees, unemployed and small businessmen. And most patients with TTH were retirees, unemployed and small businessmen. Migraine had longer disease course than TTH, seizures 2 ~ 14 days a month. The duration of the pain were from 4 to 72 hours. Most episode frequency of TTH(44.0%) were ≥15 days / month and duration range from <30 minutes to several days. Approximately 55.2% of migraine patients were throbbing headache. 64.7% of migraine sufferers described their headache as pulsating headache. The site of tension-type headache patients weremainly located in the bilateral(65.1%) and occipital(41.1%). 35.7% of tension-type headache patients showed sustained pressure or tightness, 43.2% for pain or dull ache. The degree of pain in migraine is more intense than the tension type headache. 37.9% patients with migraine and 14.9% with tension-type headache had a family history. Common predisposing factors of migraine cases were insufficient sleep(47%), menstrual phase(37.5%), blowing or weather changes(31.9%), negative psychological factors(17.7%). The common factors of induction and aggravations in patients with tension-type headache were areinsufficient sleep(35.7%), blowing or weather changes(34.9%), negative psychological factors(21.6%), fatigue(11.2%). More likely to appear in patients with migraine to get the process of headache with symptoms or signs. While the TTH has fewer simultaneous symptoms. Analgesic use frequency is higher in migraine patients than tension-type headache patients(P < 0.001).【Conclusions】20% outpatients visits to the neurology clinic with the chief complaint of headache. Primary headache is the most common type of headache in clinic. Among which, migraine and TTH have the highest rate.Women are more likely to have a headache as the chief complaint. Headache patients were younger than non-headache patients. High-risk groups of migraine were:women, above 30 years old, low and middle income, high education, rank-and-file employees and unemployed. High-risk groups of Tension-type headache were: female, above 35 years old, low and middle income, low degree, retirees and unemployed. Compared with tension-type headache, migraine has more obvious tendency of heredity. Headache attributed to psychiatric disorder is an important part of secondary headaches and need more tools and means for identification.