Classification of headache on the basis of the IHS diagnostic criteria

Objective: To test the effects of a mass-media behavioral treatment program on migraine and tension-type headache, patients with pure migraine, and with pure tension-type headache were to be selected.

Patient Selection: A random sample of 233 headache sufferers of 15,000 subscribers to the program.

Design: Patients were classified according to criteria established by the International Headache Society (IHS). Three classifications were made by a computer, a clinician, and the patient's physician. Comparison was made of the distribution of headaches types and the prevalence of the symptoms per headache type.

Results: The majority of the patients do not have pure migraine or pure tension-type headache. Many tension-type headache patients in this study group had migraine-accompanying factors. A strict application of the IHS criteria means that the category, tension-type headache, hardly exists.

Conclusion: The prevalence screening demonstrates a substantial overlap of symptoms. The consensus between the three classifications is low. According to these findings, the computer classification best fulfills the aim of selecting patients with pure migraine and pure tension-type headache.