Perception of headache-related disability in individuals with and without headache disorders working in a municipal government in the Tokyo Metropolitan Area.

Abstract

AimThe discrepancy in headache perception between people with and without headache disorders remains poorly studied. We aimed to gain insights into the factors that determine headache perception in individuals with and without headache disorders.MethodsA questionnaire-based headache survey was administered to municipal employees in the Tokyo Metropolitan Area. The participants were divided into four groups: Group A, individuals with current headache; Group B, individuals with a history of headache; Group C, individuals without headache and without nearby individuals with headaches; and Group D, individuals without headache but with nearby individuals with headaches. In Groups A and B, migraine without aura (MO), migraine with aura (MA), probable MO (pMO), and tension-type headache (TTH) were classified according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). All participants were asked about their perceptions of headaches.ResultsThe response rate was 52.3% (1156 males and 764 females). There were 518 individuals in Group A (MO, 116; MA, 93; pMO, 95; TTH, 214) and 137 in Group B (MO, 24; MA, 24; probable MO, 29; TTH, 60). In Group A, headache severity (headache intensity, duration, and frequency), visual aura, and throbbing pain contributed to the perception of headaches as disabling. Individuals with MA were more likely to consider their headaches disabling than those with TTH (p = 0.0003). However, there were no differences in the proportion of respondents who perceived headaches as disabling across headache disorders in Group B. The perception of headaches as disabling was more common in individuals without headaches (Groups C and D combined) than in those with headaches (p < 0.0001 vs. Group A; p = 0.0078 vs. Group B). However, 9.7% of them responded that headaches were not a disease. In individuals without headaches, males were more likely than females to consider headaches life-threatening (p = 0.0037). Among females, more individuals considered headaches disabling in Group D than in Group C (p = 0.0306).ConclusionHeadache severity, visual aura, and throbbing pain appear to be key therapeutic targets for attenuating headache-related disability. Headache perception varied between individuals with and without headaches, and these differences were further modified by sex among those without headaches. These findings suggest that males without headaches are more likely to perceive headaches as a serious condition, whereas females without headaches appear to be influenced by the presence of nearby individuals with headaches.