title: Prevalence, management and burden of episodic and chronic headaches--a cross-sectional multicentre study in eight Austrian headache centres.
abstract: BACKGROUND
  Episodic and chronic headaches (EH, CH) are highly prevalent disorders. Severely affected patients are usually referred to headache centres. In Austria, at least one headache centre is available in seven of nine states, but detailed multicentre data are missing. Therefore we studied prevalence rates, use of medication and health care services, impact of headaches, and comorbid depression and anxiety.
  
  
  METHODS
  We included consecutive patients from eight Austrian outpatient headache centres. The patients filled-in the Eurolight questionnaire. In addition, the treating neurologist completed a questionnaire on clinical diagnoses and ever-before prophylactic medications.
  
  
  RESULTS
  Of 598 patients screened, 441 questionnaires were analysed (79 % female, mean age 41.1 years). According to the Eurolight algorithm, 56.4 % of the patients had EH, 38.3 % had CH and 5.2 % did not give their headache frequency. The prevalence rates of migraine, tension-type headache, and probable medication overuse headache (pMOH) were 48.5 %, 6.3 % and 15.9 %, respectively. The concordance between clinical and Eurolight diagnoses was good for EH and moderate for CH. During the preceding month, acute medication was used by 90.9 % of the patients and prophylactic medication by 34 %. Ever-before use of five standard prophylactic drugs was recorded in 52.3 %. The proportion of patients with current pharmacoprophylaxis did not differ in EH and CH, whereas ever-before use was more common in CH (62.5 % was 45,3 %, p = 0.02). Patients with CH significantly more often consulted general practitioners and emergency departments, had a lower quality of life and more often signs of depression and anxiety.
  
  
  CONCLUSIONS
  This study provides comprehensive data from eight Austrian headache centres for the first time. We found a substantial number of patients with CH including pMOH and its association with more common utilization of health care facilities and greater burden. The low use of prophylactic medication requires further examination.
authors.affiliation: Department of Neurology, Medical University of Vienna, Vienna, Austria, karin.zebenholzer@meduniwien.ac.at.
authors.forename: Karin
authors.initials: K
authors.lastname: Zebenholzer
authors.forename: Colette
authors.initials: C
authors.lastname: Andree
authors.forename: Anita
authors.initials: A
authors.lastname: Lechner
authors.forename: Gregor
authors.initials: G
authors.lastname: Broessner
authors.forename: Christian
authors.initials: C
authors.lastname: Lampl
authors.forename: Gernot
authors.initials: G
authors.lastname: Luthringshausen
authors.forename: Albert
authors.initials: A
authors.lastname: Wuschitz
authors.forename: Sonja-Maria
authors.initials: SM
authors.lastname: Obmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Berek
authors.forename: Christian
authors.initials: C
authors.lastname: Wöber
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000628:therapy*; D020773:Headache Disorders / Q000453:epidemiology / Q000628:therapy*; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence