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.
Genetic Epidemiology Research Unit, Yale University School of Medicine, New Haven, CT 06510-3223.
K R
KR
Merikangas
A E
AE
Whitaker
J
J
Angst
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