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For these comparisons, the reported CIs and the corresponding p values were presented. Depression was measured both by self-report and through a validated questionnaire. Agreement between the two measures was examined using Tetrachoric correlations. Of 24 000 headache sufferers surveyed in 2005, 18 500 respondents aged 18 and older returned questionnaires. Of respondents who provided complete data necessary to assign a diagnosis and headache frequency, 655 respondents met criteria for CM and 11 249 met criteria for EM (table 1).

There were no significant differences between the two groups in gender. In comparison with EM, respondents with CM were older (CM 47.

Respondents with CM were twice as likely to have depression as measured by the PHQ-9 (CM 30. Respiratory disorders were also more often associated with CM (figure 2, table 2).

COPD, chronic obstructive pulmonary disease. Cardiovascular risk factors including high blood pressure (CM 33. It has previously been demonstrated that CM is more disabling and burdensome than EM in terms of migraine-related disability,5 HRQoL,6 healthcare costs and treatment utilisation. CM respondents were less likely to be employed full time, and more likely to be occupationally disabled. Differences in How to present a paper profiles may reflect factors associated with progression from EM to CM.

Tramadol Hydrochloride Orally Disintegrating Tablets (Rybix ODT)- Multum to the cross-sectional design of this study, it is not clear if the inverse relationship with SES reflects social selection (downward drift) or social causation (factors associated with low SES that increase risk of progression).

This question glibenclamide be explored in future longitudinal analyses. In fact, depression, chronic bronchitis, and ulcers were approximately twice as likely and chronic pain was 2.

Our primperan Tramadol Hydrochloride Orally Disintegrating Tablets (Rybix ODT)- Multum increased ORs for CM are similar to those reported in other population-based studies. Zwart et al20 reported that the odds of depression increased as headache frequency increased. They found that in comparison with control subjects without migraine, the odds of depression in migraine sufferers occurring on seven or fewer days per month was 2.

While we do not have a control sample available for comparison in our study, we found increased OR for depression of 1. Both Zwart et al's and our study found similar patterns for anxiety disorders as well.

Hagen et al15 reported that the OR for muscoskeletal symptoms (including pain) increased with increasing headache frequency. While we do not have a control sample Diclofenac Epolamine Topical System (Licart)- FDA for comparison in our study, we also found increased ORs for chronic pain in the CM group compared with the EM group of 2.

We found an OR for allergy or hay fever of 1. The strengths of this study are its large sample size, population-based format and collection of data necessary to assign ICHD-2 headache diagnoses. In response, our findings were consistent Singulair (Montelukast Sodium)- Multum other major epidemiological studies for rates of the comorbid conditions studied.

The use of self report of medical conditions is a common practice in population-based, epidemiological studies. We performed multiple comparisons, which may increase the chance of false-positive findings. Given the multitude of variables upon which EM and CM were contrasted, the probability that some significant p values were observed simply by chance may not be trivial.

However, Tramadol Hydrochloride Orally Disintegrating Tablets (Rybix ODT)- Multum the case of understudied populations, like CM, exploratory epidemiological studies are a necessary first step in the characterisation and understanding of rare but debilitating pathologies. In addition, several conditions were not found to have significantly different ORs between the EM and CM groups, including low blood pressure, cancer and premenstrual syndrome.

Finally, we were limited in the ability to examine causal relationships due to the cross-sectional design. However, we plan to address this by using longitudinal analyses in future results. Differences in the profiles between the two groups suggest that CM and EM diverge not just in the degree of headache frequency but in these other important areas.

These differences might reflect differences in biological risk factors and provide valuable clues to further explore the differences between EM and CM.

These differences may also reflect factors associated with progression from EM to CM, which may provide important clinical markers and therapeutic target areas. These findings highlight the importance for clinicians to maintain diagnostic vigilance and provide appropriate treatment or referrals when necessary. When comorbid psychiatric disorders are present with CM, it is important to take both disorders into account in formulating a treatment plan and remain mindful of the negative impact that psychiatric disorders can place on treatment outcomes, adherence and general quality of life.

Funding The AMPP is funded through a Tramadol Hydrochloride Orally Disintegrating Tablets (Rybix ODT)- Multum to the National Headache Foundation from Ortho McNeil-Pharmaceuticals. Additional funding for this manuscript was provided by Allergan Pharmaceuticals. CT and AM are full-time employees of Allergan Pharmaceuticals, Irvine, California. Competing interests Dr Buse has Tramadol Hydrochloride Orally Disintegrating Tablets (Rybix ODT)- Multum honoraria from Allergan, Endo, Merck, MAP and Iroko Pharmaceuticals.

Ethics approval Ethics approval was provided by the Albert Einstein College of Medicine, Bronx, NY. MethodsStudy designThe AMPP study is a longitudinal, population-based study based on an annual, mailed questionnaire. Study populationA cross-sectional analysis of the 2005 AMPP study data was utilised to assess differences between two groups of respondents: CM and EM. Description of the surveyThe 2005 AMPP survey was a self-administered questionnaire comprising 60 items assessing demographics, headache characteristics, frequency, severity, other necessary information to assign an ICHD-II diagnosis, comorbidities, headache-related burden, impact on work and other aspects of life, health-related quality of life and other information of interest.



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