title: The impact of migraine on quality of life in the general population: the GEM study.
abstract: OBJECTIVE
  To assess health-related quality of life (HRQOL) in migraineurs in the general population.
  
  
  METHODS
  Cross-sectional study within the context of a population-based study monitoring health characteristics of the Dutch adult population in two municipalities representative of the general population in the Netherlands. Migraine was assessed in a multistaged procedure that included a semistructured clinical interview by telephone. Final diagnosis met 1988 International Headache Society criteria. HRQOL was measured with the self-administered RAND 36-item Health Survey (RAND-36), including physical functioning, social functioning, role limitations, and physical perception. HRQOL of migraineurs was compared with that of nonmigraineurs. To compare and study the effect of comorbidity, the authors also identified subjects with asthma or chronic musculoskeletal pain. There were 5998 people with complete data, 620 of whom had migraine in the last year.
  
  
  RESULTS
  Compared with nonmigraineurs, significantly more migraineurs had asthma (OR = 1.6; 95% CI 1.1, 2.4) or chronic musculoskeletal pain (OR = 1.7; 95% CI 1.5, 2.1). Migraineurs reported diminished functioning and well-being on all eight domains as compared with nonmigraineurs. HRQOL was inversely related to attack frequency (p < 0.0002). Migraineurs had a poorer HRQOL than did those reporting asthma, except for dimensions concerning physical functioning and general health perception, but they had a better HRQOL than did subjects with chronic musculoskeletal pain. Comorbidity of asthma or chronic musculoskeletal pain in migraine further reduced HRQOL.
  
  
  CONCLUSIONS
  Migraineurs report more asthma and chronic musculoskeletal pain. Compared with nonmigraineurs and to others with chronic conditions, migraineurs report compromised physical, mental, and social functioning, particularly those with a high frequency of attack.
authors.affiliation: Department of Neurology, Leiden University Medical Centre, The Netherlands.
authors.forename: G M
authors.initials: GM
authors.lastname: Terwindt
authors.forename: M D
authors.initials: MD
authors.lastname: Ferrari
authors.forename: M
authors.initials: M
authors.lastname: Tijhuis
authors.forename: S M
authors.initials: SM
authors.lastname: Groenen
authors.forename: H S
authors.initials: HS
authors.lastname: Picavet
authors.forename: L J
authors.initials: LJ
authors.lastname: Launer
mesh_terms: D000328:Adult; D001249:Asthma / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology* / Q000503:physiopathology*; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires