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本邦における片頭痛の有病率はどの程度か

 

1) Sakai F, Igarashi H. Prevalence of migraine in Japan : a nationwide
　 survey. Cephalalgia 1997; 17(1):15-22.
論文抄録
This study presents the first nationwide survey of migraine in Japan . A representative sample of 4029 subjects aged 15 years or older was selected from the Japanese population according to the quota method. A combination of telephone interview and mailed questionnaire methods was used. Diagnosis of migraine was based on the International Headache Society (IHS) Classification. The overall prevalence of migraine in the past year was 8.4%; 5.8% was migraine without aura and 2.6% was migraine with aura. Significant correlation was found between the prevalence of migraine and such variables as gender, age and district of residence. Doctor attendance rate was very low and 69.4% with migraine had never consulted a physician for headache. Yet, 74.2% complained that migraine headache impaired their daily activity significantly. Only 11.6% were aware that their headache was migraine and 56.9% were using only the over-the-counter drugs. The study revealed a comparably high prevalence of migraine in the general population of Japan compared with other countries. A genetic factor was speculated as the cause of regional difference in migraine prevalence
文献 PubMed−ID

PM:9051330

エビデンスレベル

III

文献タイトル (日本語)

日本における片頭痛の有病率：全国調査。

目的
日本における片頭痛有病率を明らかにする
研究デザイン
代表的サンプルに対する電話調査と郵送アンケートによる調査
研究施設
北里大学医学部・内科
対象患者

15歳以上の4029人，割当法によって日本の人口構成に対応さｓて選択

介入
電話による調査と郵送によるアンケート調査の組合せにより調査
主要評価項目とそれに用いた
統計学的手法
片頭痛の診断は、国際頭痛学会（ IHS）分類に準拠．
結果

全体の年間片頭痛有病率は、 8.4%
5.8%は前兆のない片頭痛．2.6%は前兆のある片頭痛．
片頭痛の有病率と有意な相関を示す因子として，性別，年齢，居住地域が見出された．
受診率は非常に低く，片頭痛患者の 69.4%は一度も頭痛のために受診したことがない．
74.2%の片頭痛患者は片頭痛により有意な日常活動の阻害があると回答した．自分の頭痛が片頭痛であると認識しているのはわずか 11.6%だけであった．56.9%は市販の頭痛薬のみを使用していた．
結論
日本の片頭痛有病率は、 8.4%で，他の国と同様に高い有病率である．片頭痛患者の受診率は低い．有病率の地域差は遺伝的な要因が示唆された．
コメント
本邦における，最初の科学的な頭痛疫学調査．
作成者
竹島多賀夫

 

2) Takeshima T, Ishizaki K, Fukuhara Y et al. Population-based door-to-
　 door survey of migraine in Japan : the Daisen study. Headache. 2004;
　 44:8-19

論文抄録

OBJECTIVES: To determine prevalence and characteristics of migraine in Japan , and to investigate use of medical care and whether food preference is associated with risk of migraine. METHODS: Structured questionnaires were given to all adult residents (N = 5758; 2681 men and 3077 women) in Daisen, a rural community in western Japan . Second questionnaires, specific to headache, were given to 1628 residents with headache. A telephone survey was also carried out. Statistical Packages for the Social Sciences analyzed the data. RESULTS: The 1-year prevalence of migraine was 2.3% (migraine with aura, 0.4% and without aura, 1.9%) in men and 9.1% (migraine with aura, 1.0% and migraine without aura, 8.1%) in women. Overall prevalence of migraine in Daisen was 6.0% (95% confidence interval [CI], 5.4% to 6.6%). Women observed a 5.9-fold higher risk of migraine than men (odds ratio, 5.9; 95% CI, 4.5 to 8.0; P <.0001, after age adjustment, by logistic analysis). Fatigue and loss of vigor were predominant premonitory symptoms of migraine. Fatigue, mental stress, and lack of sleep were the main headache triggers. Over a 3-month period, 20.3% of migraineurs experienced time or days off work due to headache. Only 7.3% of those with migraine with aura and 5.3% of those with migraine without aura had consulted a physician, and of those with migraine, 61.0% with aura and 71.8% without aura had never visited a medical doctor for their headache. Consumption of alcohol and cigarette smoking did not influence the risk for migraine or tension-type headache, after age and gender adjustment (logistic analysis). Migraineurs consume significantly more fatty/oily foods, coffee, and tea than nonheadache subjects of the same community. Migraineurs consume significantly fewer fish than nonheadache residents. CONCLUSIONS: Only a few Japanese migraineurs receive benefits of medical services and recent advances of headache medicine. Public education concerning headaches is one of the most urgent issues in Japan

文献 PubMed−ID

PM:14979878

エビデンスレベル

III

文献タイトル (日本語)

日本における片頭痛の住民全戸調査：大山研究

目的

日本の片頭痛の有病率，臨床的特徴を明らかにし，片頭痛患者の医療サービスの利用状況を調査し，食事の嗜好が片頭痛のリスクになるか検討する．

研究デザイン

住民全戸調査：アンケート +電話調査

研究施設

鳥取大学医学部・脳神経内科

対象患者

大山町民の成人， 5758 名（男性 2681 名，女性 3077 名）

介入

アンケート調査

主要評価項目とそれに用いた統計学的手法

logistic analysis

結果

年間，片頭痛有病率は男性 2.3 ％（ MA0.4 ％， MO1.9 ％），女性 9.1 ％（ MA1.0 ％， MO8.1 ％）
全体の片頭痛粗有病率 6.0 ％（ 95 ％ CI: 5.4%- 6.6% ）
過去 3 ヶ月の間に片頭痛患者の 20.3 ％は頭痛のために仕事が出来ない経験をしている．
MA の 7.3 ％， MO の 5.3 ％のみが定期的に頭痛のために医師にかかっており， MA の 61 ％， MO の 72 ％は，頭痛のために医療機関を受診したことが一度もない．
年齢と性を補正すると，飲酒量，喫煙は片頭痛，緊張型頭痛のリスクにはならなかった (logistic analysis).
片頭痛患者は脂肪の多い食事，コーヒー / 紅茶の摂取量が有意に多く，魚の摂取量が有意に少なかった．

作成者

竹島多賀夫

 

3) Lipton RB, Scher AI, Kolodner K et al. Migraine in the United States :
　 Epidemiology and patterns of health care use. Neurology. 2002; 58:885-
　 894

文献 PubMed−ID

PM:11914403

文献タイトル (日本語)

米国における片頭痛：疫学と医療受給パターン

論文抄録

OBJECTIVE: To determine the prevalence and distribution of migraine in the United States as well as current patterns of health care use. METHODS: A random-digit-dial, computer-assisted telephone interview (CATI) survey was conducted in Philadelphia County , PA , in 1998. The CATI identifies individuals with migraine (categories 1.1 and 1.2) as defined by the diagnostic criteria of the International Headache Society with high sensitivity (85%) and specificity (96%). Interviews were completed in 4,376 subjects to identify 568 with migraine. Those with 6 or more attacks per year (n = 410) were invited to participate in a follow-up interview about health care utilization and family impact of migraine; 246 (60.0%) participated. RESULTS: The 1-year prevalence of migraine was 17.2% in females and 6.0% in males. Prevalence was highest between the ages of 30 and 49. Whereas 48% of migraine sufferers had seen a doctor for headache within the last year (current consulters), 31% had never done so in their lifetimes and 21% had not seen a doctor for headache for at least 1 year (lapsed consulters). Of current or lapsed consulters, 73% reported a physician- made diagnosis of migraine; treatments varied. Of all migraine sufferers, 49% were treated with over-the-counter medications only, 23% with prescription medication only, 23% with both, and 5% with no medications at all. CONCLUSION: Relative to prior cross-sectional surveys, epidemiologic profiles for migraine have remained stable in the United States over the last decade. Self-reported rates of current medical consultation have more than doubled. Moderate increases were seen in the percentage of migraine sufferers who use prescription medications and in the likelihood of receiving a physician diagnosis of migraine