• Parviz Bahrami, Hatam Zebardast, Mohammad Zibaei, Mina Mohammadzadeh, and Neda Zabandan.
• Neurology Department, Khoramabad University of Medical Sciences, Lorestan, Iran. drbahrami2003@yahoo.com
• Pain Physician. 2012 Jul 1;15(4):327-32.

BackgroundHeadache is a prevalent and disabling condition affecting people in all age groups worldwide, leading to low job performance and quality of life with a significant economic burden on societies.ObjectiveWe evaluated headache prevalence and characteristics and some probable associated factors in patients referring to neurology specialist clinics.Study DesignCross sectional studySettingClinics of Khoramabad and also those referring to the emergency department of Khoramabad University Hospital.MethodsOne thousand patients with a chief concern of headache were assigned to the study. All patients filled out a structured questionnaire to gather demographic information and data on headache characteristics and associated factors, including past medical and psychiatric history, history of oral contraceptive pill (OCP)  use, nonsteroidal anti-inflammatory drug (NSAID) overuse, and menstruation.ResultsThe total prevalence of primary headaches was 78.2%, with migraine (with and without aura) being the most prevalent type with a prevalence of 41.6% followed by tension type headache found in 31.6% of the study population. Primary headaches were significantly more common in women and younger age groups. Factors found associated with a significantly higher prevalence of primary headaches were lower economic level, higher educational level, occupation, OCP use and NSAIDs overuse. Secondary headaches, with a total prevalence of 20.1%, significantly increased in older age groups and higher economic levels and were significantly less prevalent in higher educational levels.LimitationsThe study population is not quite representative of the general population of Iran.ConclusionResults highlight the impact of socioeconomic factors on headache epidemiology in a developing country and demonstrate that OCPs and NSAIDs overuse might have an effect on the distribution of primary headaches.  Further multicenter studies are needed to evaluate headache epidemiology in the whole country.

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