Abstract

Objective: Education reflects socioeconomic status and may influence pain modulation or thresholds in primary headache disorders. Tension-type headache(TTH) is the most common type of primary headache and the influence of education on the prevalence of TTH has not been well evaluated. The aims of this study were to evaluate the asso- ciation between education level and the prevalence of TTH and the influence of other contributors. Methods: For this study, a stratified random population sample of Koreans, over the age of 19, was selected and evalua- ted using a 12-item, semi-structured interview designed to identify headache type using ICHD-2 criteria. Education levels were classified into college, high school, and middle school or below. Household income and occupation were evaluated as contributors. Results: Among 1507 participants, 463(30.7%) were diagnosed with TTH; 228 were frequent episodic TTH, 224 were infrequent episodic TTH, and 11 were chronic TTH. College level was associated with a lower prevalence of tension-type headache(25.8% vs 33.8% in high school, 32.9% in middle school or below, p=0.006). Prevalence of frequent episodic TTH was lower in college graduate(p=0.002). After adjusting age, gender, and income, education level is the significant contributor for prevalence of TTH. Conclusions: Among variables of socioeconomic status, education is the important modulator of TTH, especially in women.