Clinical characteristics of tension-type headache in the neurological clinic of a university hospital in China

The aim of this study was to investigate the clinical characteristics and patterns of diagnosis and treatment of patients with tension-type headache in the neurology outpatient clinic of a university hospital in China. This cross-sectional study was conducted in the neurological clinic of a tertiary care hospital in Chongqing between March 2010 and May 2010. All consecutive patients with the chief complaint of headache were asked to complete a face-to-face interview with physicians. A questionnaire for collecting data of headache patients was completed by a qualified physician. Headache diagnosis was made by physicians according to the criteria of the second edition of the International Classification of Headache Disorders. A total of 399 patients were diagnosed as having tension-type headache, around two-thirds of them (66.9%) were female and the mean age was 44.8 ± 12.8 years. Approximately, half of the patients were diagnosed as suffering from chronic tension-type headache. Of all tension-type headache sufferers, 64.9% had consulted a physician for headache in the previous year, and only 22 patients (5.6%) had received a physician diagnosis of tension-type headache. A total of 41.4% of patients took analgesic for acute treatment and 13.3% were considered to have medication overuse, however, none had ever used any preventative medications. In conclusion, many tension-type headache patients did not receive a physician diagnosis of tension-type headache or effective treatment in the neurological clinic. Tension-type headache remains underrecognized in China. Better education among physicians is needed so as to improve the diagnosis and treatment of tension-type headache.