title: New daily persistent headache: should migrainous features be incorporated?
abstract: BACKGROUND
  International Classification of Headache Disorders (ICHD-2) criteria for new daily persistent headache (NDPH) require tension-type headache features. Many patients with 'new-onset persistent' headache fail to fulfil such criteria due to prominent migrainous features.
  
  
  METHODS
  We reviewed all NDPH patients in our headache clinic, using the definition of persistent headache < 3 days after onset for > 3 months. The patients were dichotomised: patients meeting ICHD-2 criteria (NDPH-S) and patients failing to meet ICHD-2 criteria due to prominent migrainous features (NDPH-M). All patients had completed a structured intake form including demographics, headache profiles, Beck Depression Inventory (BDI), Short Form 36 (SF-36) Health Survey, and Migraine Disability Assessment (MIDAS). A telephone interview was conducted for follow-up.
  
  
  RESULTS
  A total of 92 NDPH patients were enrolled (59 (64.1%) NDPH-M, 33 (35.9%) NDPH-S). Between the two subgroups, the sociodemographics were indistinguishable, but the patients with NDPH-M had higher headache intensity, BDI scores, MIDAS scores, and lower scores of most SF-36 subscales. After an average of 2 years of follow-up, 57 (66%) had a good outcome (≥ 50% reduction in headache frequency). Cox proportional analysis showed that disease duration ≤ 6 months and NDPH-S diagnosis predicted good outcomes.
  
  
  CONCLUSIONS
  Migrainous features were common in patients with NDPH. Unlike prior studies, our study showed NDPH-M represented a more severe subgroup with a poorer outcome compared with NDPH-S.
authors.affiliation: Taipei Veterans General Hospital, Taiwan.
authors.forename: Kuan-Po
authors.initials: KP
authors.lastname: Peng
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
authors.forename: Hsiang-Kuo
authors.initials: HK
authors.lastname: Yuan
authors.forename: Ben-Chang
authors.initials: BC
authors.lastname: Shia
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D009626:Terminology as Topic; D016896:Treatment Outcome; D055815:Young Adult