A Survey of Headache Medicine Physicians on the Likeability of Headaches and Their Personal Headache History

Background Two prior studies have shown an increased prevalence of migraine among physicians who are headache medicine specialists (HMS). There have been no studies of the prevalence of other headache disorders among HMS. A prior survey showed that neurologists like to treat some headaches more than others but there has not been a similar survey of HMS. Objectives The aim of the survey was to learn more about the prevalence of headaches among HMS and which headache disorders they like to treat. Methods An email survey was sent to 749 physician members of the American Headache Society who were asked to respond to the following statement using a 5-point Likert scale (from 1, strongly disagree to 5, strongly agree): "I like to treat patients with the following types of headaches or syndromes." They were asked, "Have you personally suffered from any of the following at any time during your life: episodic migraine (EM), chronic migraine (CM), refractory migraine (RM), episodic cluster (EC), chronic cluster (CC), new daily persistent headache (NDPH), and postconcussion syndrome (PCS)." Results The response rate was 15.8% (n = 118) with a mean age of 51.4 years, 64.4% males, and 85.6% neurologists. HMS reported likeability for treating disorders in rank order as follows: EM (mean = 4.69, SD = 0.61); CM (mean = 4.20, SD = 0.94); RM (mean = 3.62, SD = 1.17); EC (mean = 4.37, SD = 0.80); CC (mean = 3.68, SD = 1.10); NDPH (mean = 3.52, SD = 1.21); and PCS (mean = 3.66, SD = 1.18). The lifetime prevalence of disorders was as follows: EM, 69.5% (85.7% in females and 60.5% in males); CM, 13.6% (19% in females and 10.5% in males); RM,.9% (2.4% females and 0% males); EC, 1.7% (0% females and 2.6% males); CC, 0%; NDPH, 0%, and PCS, 4.2% (7.1% females and 2.6% males). HMS with a personal history of EM (mean = 4.73, SD = 0.51) showed a significant preference (t₁₃₀ = 7.30, P <.001) to treat episodic migraine more than other headaches (mean = 3.90, SD = 0.77). Conclusions HMS preferred to treat some disorders more than others, with EM most liked and NDPH least preferred, which may reflect how well patients with those disorders respond to treatment. The lifetime prevalence of EM among HMS is significantly greater than among neurologists, both significantly greater than EM in the general population. An explanation for the higher prevalence among neurologists is not certain but perhaps migraine is associated with a choice to become an HMS during or after neurology residency. The lifetime prevalence among HMS of CM may be and EC is much greater than among the general population for uncertain reasons.