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Risk Factors for Headache in the UK Military: Cross‐Sectional and Longitudinal Analyses
Author(s) -
Rona Roberto J.,
Jones Margaret,
Goodwin Laura,
Hull Lisa,
Wessely Simon
Publication year - 2013
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12101
Subject(s) - medicine , cross sectional study , odds ratio , confidence interval , physical therapy , pathology
Aims To assess the importance of service demographic, mental disorders, and deployment factors on headache severity and prevalence, and to assess the impact of headache on functional impairment. Background There is no information on prevalence and risk factors of headache in the UK military. Recent US reports suggest that deployment, especially a combat role, is associated with headache. Such an association may have serious consequences on personnel during deployment. Methods A survey was carried out between 2004 and 2006 (phase 1) and again between 2007 and 2009 (phase 2) of randomly selected UK military personnel to study the health consequences of the I raq and A fghanistan wars. This study is based on those who participated in phase 2 and includes cross‐sectional and longitudinal analyses. Headache severity in the last month and functional impairment at phase 2 were the main outcomes. Results Forty‐six percent complained of headache in phase 2, half of whom endorsed moderate or severe headache. Severe headache was strongly associated with probable post‐traumatic stress disorder (multinomial odds ratio [ MOR ] 9.6, 95% confidence interval [ CI ] 6.4‐14.2), psychological distress ( MOR 6.15, 95% CI 4.8‐7.9), multiple physical symptoms ( MOR 18.2, 95% CI 13.4‐24.6) and self‐reported mild traumatic brain injury ( MOR 3.5, 95% CI 1.4‐8.6) after adjustment for service demographic factors. Mild headache was also associated with these variables but at a lower level. Moderate and severe headache were associated with functional impairment, but the association was partially explained by mental disorders. Mental ill health was also associated with reporting moderate and severe headache at both phase 1 and phase 2. Deployment and a combat role were not associated with headache. Conclusion Moderate and severe headache are common in the military and have an impact on functional impairment. They are more strongly associated with mental disorders than with mild traumatic brain injury.