Quality-of-life assessment in patients with headache.

Although headache is the most common pain complaint seen by primary care physicians, the measurement of quality of life in patients with headache is in its earliest stages. Most of the research has been published within the past 2 years, much of it only in abstract form. Quality-of-life data derived from the Medical Outcomes Study instrument (SF-20) demonstrate that chronic headache disorders are associated with significant limitations in all 6 health categories of patient well-being and functioning. The outcomes profile for each of the common benign headache disorders appear to be unique for the specific headache diagnosis. Migraine is primarily associated with an impairment in role (work) functioning. Chronic tension-type headache is associated with a marked impairment in mental health and a generalised impairment in functioning. Cluster headache is associated with the greatest amount of pain, but with little impairment in physical functioning. The economic toll of recurrent headache is considerable. Lost productivity in the US due to migraine is estimated at $US6.5 to 17.2 billion per year. Chronic headache disorders cause significantly more morbidity, impairment of function, and economic loss than has previously been recognised.