Publication year
2011
Citation Title
Headache disorders in the millennium cohort: Epidemiology and relations with combat deployment.
Journal Name
Headache: The Journal of Head and Face Pain
Journal Volume
51
Issue Number
7
Page Numbers
1098-1111
DOI
10.1111/j.1526-4610.2011.01914.x
Summary
Service members from all branches of the military completed paper-and-pencil surveys as part of the Millennium Cohort Study. Researchers were interested in exploring the association between deployment and combat exposure with migraine and headache disorders. Results indicate that Service members who had been deployed were more likely to experience new onset headaches, including migraines, recurrent severe headaches, and headaches that “bother you a lot."
Key Findings
The prevalence of headache conditions (i.e., migraines, recurrent severe headaches, and headaches that “bother you a lot”) largely paralleled the rates among civilian population (e.g., 3-9% for men, and 10-27% for women).
Experiencing a combat deployment significantly increased a Service member’s likelihood of experiencing new onset headache conditions (1.72 times more likely for men, 1.84 times more likely for women).
Several other factors also were associated with headache conditions; Service members who were younger, enlisted, Army Soldiers, and those who have a diagnosis of posttraumatic stress disorder, depression, or other anxiety disorders were more likely to have headache problems.
Implications for Program Leaders
Distribute information headache risk factors, symptoms, and treatment options (e.g., over the counter medications, behavior changes, seeking medical treatment)
Educate their staff by offering continuing education regarding headache conditions (e.g., when to recommend seeking professional assistance, treatment options)
Offer support groups for Service members and families coping with physical health issues post-deployment, including headache disorders
Implications for Policy Makers
Recommend that practitioners assess and monitor headache-related symptoms or conditions after a Service member receives a diagnosis of PTSD, depression, or anxiety disorders
Encourage the development of services that address both physical and mental health issues post-deployment
Promote efforts that mitigate psychological and physical stressors during deployment to reduce the risk of headache disorders post-deployment
Methods
Participants were drawn from the Millennium Cohort Study, a 24-year longitudinal study that follows over 75,000 Service members representing each of the branches.
The study involved mail-in paper-and-pencil surveys that participants completed between July 2001 and June 2003.
Deployment information and demographic data were accessed via the Defense Manpower Data Center.
Participants
Thirty-eight thousand six hundred thirty-one Service members from all branches were included in this study.
Twenty-five percent of the sample were women.
No other demographic information about the entire sample was provided in this article.
Limitations
This study only examined one aspect of deployment, namely combat experience; however, other features of deployment (e.g., injury, duties, length of deployment) may also play a role in new onset headache conditions.
The data for the Millennium Cohort study was collected via postal mail; as such, the sample is limited to only those who completed the survey and returned it which may bias the results.
The researchers only examined specific headache conditions; this narrow scope limits the findings of this study to those specific problems.
Avenues for Future Research
Examine whether injury during combat (e.g., Traumatic Brain Injury) plays a role in the connection between combat deployment and headache conditions
Explore differences in the likelihood of headache conditions of different severity (i.e., comparing mild chronic headaches and extremely severe chronic headaches)
Investigate how headaches might be impacting other parts of Service members’ lives, including work attendance and family relationships
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Abstract
Objective.— Characterize migraine and other headache disorders within a large population-based US military cohort, with an emphasis on the temporal association between military deployment and exposure to combat. Background.— Little research has been published on the prevalence of headache disorders in the US military population, especially in relation to overseas deployments and exposure to combat. A higher than expected prevalence of migraine has previously been reported among deployed US soldiers in Iraq, suggesting an association. Headache disorders, including migraine, could have important effects on the performance of service members. Methods.— A total of 77,047 US active-duty, Reserve, and National Guard members completed a baseline questionnaire between July 2001 to June 2003 for the Millennium Cohort Study. Headache disorders were assessed using the following survey-based measures: self-reported history of provider-diagnosed migraine, recurrent severe headache within the past year, and recent headaches/bothered a lot within the past 4 weeks. Follow-up surveys were completed on average 3 years after baseline (mean = 2.7 years; range = 11.4 months to 4.5 years). Results.— The overall male and female prevalence of self-reported headache conditions at baseline were: provider-diagnosed migraine, 6.9% and 20.9%, respectively; recurrent severe headache, 9.4% and 22.3%, respectively; and bothered a lot by headaches, 3.4% and 10.4%, respectively. Combat deployers had significantly higher odds of any new-onset headache disorders than non-deployers (adjusted odds ratios = 1.72 for men, 1.84 for women; 95% confidence intervals, 1.55-1.90 for men, 1.55-2.18 for women), while deployers without combat exposure did not. Conclusions.— Deployed personnel with reported combat exposure appear to represent a higher risk group for new-onset headache disorders. The identification of populations at higher risk of development of headache provides support for targeted interventions.
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