Validation of diagnostic criteria for migraine in the Zürich longitudinal cohort study.
This paper reports the results of a systematic assessment of the validity of the specific diagnostic criteria for migraine without aura, as defined by the International Headache Society (IHS), in a longitudinal epidemiologic sample of young adults who were selected from the general population of Zürich, Switzerland. Systematic modification of each of the IHS criteria for migraine without aura yielded one-year weighted prevalence rates ranging from 24% for the unmodified IHS criteria to 9% for the most restrictive definition of migraine. The major implications of the findings for the IHS criteria are: (a) they provide adequate coverage to classify the majority of subjects with headache in the general population; (b) there is little overlap between migraine and tension-type headache, suggesting that the criteria define moderately independent subgroups; (c) the criteria for migraine without aura appear to be too unrestrictive for application in the community, particularly among young adults at the peak period of incidence of migraine; (d) the criteria for "aura" need more precise operationalization; and (e) models of validation of the diagnostic criteria suggest that Criterion D of the IHS criteria for migraine without aura should be modified to require both gastrointestinal symptoms and photophobia and phonophobia.
Merikangas
K R
KR
Genetic Epidemiology Research Unit, Yale University School of Medicine, New Haven, CT 06510-3223.
Whitaker
A E
AE
Angst
J
J
D000328:Adult; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006261:Headache / Q000145:classification / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis*; D009119:Muscle Contraction; D009316:National Institutes of Health (U.S.); D015995:Prevalence; D012008:Recurrence; D012044:Regression Analysis; D012720:Severity of Illness Index; D012955:Societies, Medical; D014481:United States