Physician consultation for headache pain and history of panic: results from a population-based study

In a population-based telephone interview survey of 10,169 respondents aged 12-29 years in Washington County, Maryland, data were collected on history of panic attacks, on the most recent headache and associated symptoms in the 2 weeks before the interview, and on physician consultation for headache-related problems. Of those who had a headache in the previous 12 months, 14.2% of females and 5.8% of males consulted a physician for headache. The proportion who recently consulted a physician increased with age among females but not among males. An unexpectedly high proportion of those who recently sought physician care for their headache problem had a history of panic. In particular, among those who sought care, 15% of females and 12.8% of males ages 24-29 had a history of panic disorder. Overall, females with panic disorder who had recently seen a physician for headache exhibited the most frequent, severe, and complex headaches. In particular, headaches were of considerably longer duration, more severe, and greater than 50% of these females had five or more headaches in a 4-week period. A very high proportion experienced disability (up to 46.7%) from their headache. Males with a history of panic who did or did not seek physician care differed only in that a considerably higher proportion of the former group (up to 45%) had frequent headaches. Overall, 11.8% of the total population had a migraine headache in the 2 weeks before the interview. In contrast, 21.8% of those who sought physician care and 36% of those with panic disorder who sought physician care had a migraine headache.