Prevalence and clinical characteristics of headache in medical students in Oman

Objectives.-To perform a descriptive epidemiological study of headache in medical students at Sultan Qaboos University, analyzing prevalence, symptom profile, and pattern of health care utilization. Background.-Headache is one of the most common complaints in medical practice. To our knowledge, headache has not been the subject of investigation in medical students in the Arabian Gulf. Methods.-Lifetime and last-year prevalence of headache was based on a detailed structured headache assessment questionnaire. Besides demographic data, headache characteristics and pattern of health care utilization were evaluated. In addition, questions were included referring to the use of traditional remedies. Interviewers included three previously trained final-year medical students. The evaluation was done per cohort, and the students were guided through the assessment questionnaire by the interviewers. Migraine and tension-type headache were diagnosed according to the criteria of the International Headache Society. Results.-Four hundred three students (95.3%) completed the questionnaire: 151 men (37.5%) and 252 women (62.5%). The lifetime and last-year prevalence of headache was 98.3% and 96.8%, respectively. A positive family history of headache was found in 57.6% of students. The prevalence rate of migraine and tension-type headache was found to be the same (12.2%), with a difference in distribution across sexes: 6.6% of the men and 15.5% of the women had migraine, while 13.9% of the men and 11.1% of the women suffered from tension-type headache. Only 23.3% of students sought medical assistance during headache episodes, and 80.3% took medication: 24.6% took prescribed medication, 72.9% took nonprescription medication, and only 2.5% took traditional remedies. Acetaminophen (83.1%) followed by mefenamic acid (24.6%) were the most commonly used drugs. Conclusions.-The results of this prospective epidemiological study show that headache is highly prevalent among medical students at this university. The high prevalence rate of migraine sufferers in this student population might be due to the high female-to-male ratio (1.7:1). It is likely that analgesic use/overuse also coexists with headache in medical students at Sultan Qaboos University, since a large majority of them rely on nonprescription medications.