Low rate of self-awareness and medical recognition of migraine in Germany.
OBJECTIVE
The study's objective was to assess self-awareness and medical recognition of migraine and their determinants in Germany.


METHODS
We conducted a nationally representative study of the general population of Germany (N = 7341, aged ≥18 years) by means of computer-assisted telephone interviews. Migraine was diagnosed based on the International Classification of Headache Disorders, second edition (ICDH-II).


RESULTS
Twelve-month prevalence of ICHD-II-migraine was 10.6% (women 15.6%, men 5.3%). Seventy percent of ICDH-II-migraineurs recognised their headaches as migraine (moderate agreement between ICDH-II and self-diagnosis, κ = 0.46). Only 42% of migraineurs consulted a physician in the previous 12 months. Of those, 63% reported a medical diagnosis of migraine (moderate agreement, κ = 0.40). Women were more likely to be self-aware (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.27-2.60), but the difference was no longer significant when adjusting for migraine features. Physician recognition was more likely in patients with higher educational level (high vs. low education OR 3.90, 95% CI 1.43-10.61 after adjusting for migrainous features). Best predictors for self-awareness and medical recognition of migraine were typical migraine accompaniments and greater headache intensity.


CONCLUSIONS
Self-awareness and physician recognition of migraine are low in Germany. Presence of typical migraine features and greater headache intensity facilitate medical recognition and awareness of migraine, especially in females.
Department of Neurology, Charité, 13353 Berlin, Germany. andrea.radtke@charite.de
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D000328:Adult; D000368:Aged; D004522:Educational Status; D005260:Female; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D038801:International Classification of Diseases; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012494:Sampling Studies; D012648:Self Care; D012680:Sensitivity and Specificity; D012737:Sex Factors; D063189:Symptom Assessment; D055815:Young Adult