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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A survey of the psychological characteristics of a large sample of chronic headache cases (n = 360), including classical and common migraine and tension headache sufferers, was carried out. Comparing groups defined in terms of the chronicity of their headache problems, it was found that those with a longer history of headache had a higher level of behavioural disruption and a stronger bond between pain experience, and both complaint levels and behavioural avoidance patterns. Despite the common somatic components (sleep disturbance, fatigue, irritability, etc.), depression was not found to be elevated in this chronic pain group. In addition, there was no evidence of depression levels being higher in the populations who had had a longer history of headache problems. Higher levels of complaint were found in those with higher depression and higher extroversion and neuroticism scores. Behavioural avoidance was significantly related to the emotional reaction component of pain. The implications of these findings with respect to the development of chronic headache are discussed.
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PMID:The effects of persistent pain: the chronic headache sufferer. 398 40

One hundred and three patients referred to a neurological outpatient clinic were examined to assess the relationship between persistent headache, not due to significant physical illness, and emotional disturbance. Overall, the patients showed slightly more evidence of emotional disturbance than a general practice population but less than psychiatric outpatients. Thus, with cut-off points of 4/5 and 9/10 on the General Health Questionnaire (GHQ 28) the whole group had 52% or 20% of psychiatric 'cases' respectively. On the Crown-Crisp Experiential Index the 70 females had mean total scores of 37.19 +/- 11.11 and the 33 males had scores of 31.79 +/- 11.36. In addition the childhood experiences measured by the Parental Bonding Instrument appeared to be normal. Seven patients had significant depressive illness, according to the Levine-Pilowsky Depression Questionnaire. Statistically significant differences in psychological state did not emerge between the diagnoses of cluster headache, classical migraine, common migraine, tension headache or combined headache. However, negative correlations were found between the duration of illness and measures of anxiety. It is concluded that although the emotional state contributes to the development of pain and headache in some patients, there are others in whom comparable headaches are unlikely to be due to emotional factors. Selection effects are held to be important and some of the emotional changes will vary at different phases of a chronic disorder. A new symptom may initially cause anxiety but when a condition persists some patients will be increasingly concerned or depressed whilst others develop tolerance for the situation.
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PMID:Psychological normality and abnormality in persistent headache patients. 405 27

In a Finnish general practice 120 patients with psychosomatic disorders, manifest as syndromes of tension headache, cardiac neurosis, dizziness or muscular tension, were randomly allocated to treatment over a 4-week period with either flupenthixol (1 to 2 mg per day) or diazepam (5 to 10 mg mg per day). The 4 syndromes and 12 associated symptoms (anxiety, fatigue, depression, pain, asthenia, muscle fatiguability, tension, dyspnoea, restlessness, palpitations, sleep disorders, and vertigo) were rated on a 4-point scale on entry, at 2 weeks and at 4 weeks. Both drugs reduced significantly the average total scores for syndromes and single symptoms after 2-weeks' treatment. Flupenthixol was the more effective in relieving fatigue and vertigo; diazepam in relieving headache, anxiety, tension, restlessness and sleep disturbance. Cardiac neurosis, palpitations and general muscular tension responded poorly to both drugs. After 4 weeks, relief of vertigo, pain and fatigue was more evident in the flupenthixol group, and of anxiety, tension and restlessness in the diazepam group. Side-effects were complained of at some stage by 17 patients in the flupenthixol group (9 of fatigue, 5 of sleep disturbance, 1 of constipation, 1 of extrapyramidal symptoms, and 1 of weight gain) and by 16 patients in the diazepam group (10 of fatigue, 4 of sleep problems and 2 of diarrhoea).
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PMID:Flupenthixol versus diazepam in the treatment of psychosomatic disorders: a double-blind, multi-centre trial in general practice. 637 78

71 women were examined daily for the presence of headache in their first post partum week. Post natal headache (PNH) occurred in 27, (39%) of the women and was most frequent on days 4-6 post partum. PNH was significantly associated with a previous or family history of migraine and pre-menstrual migraine. Although 83% of those with PNH had a migraine diathesis, they did not describe their headache as one of their usual migraines as it was considerably milder. Headaches were more frequent among multigravida but as rather more multigravida had a previous migraine diathesis this may reflect a sampling bias. PNH subjects had significantly more tension and depression suggesting that at least some PNH may be tension headache. Around 3 or 4 days post partum, women began to lose weight and the onset of headache often coincided with the start of this weight loss. 12 women with, and 12 without PNH took part in a metabolic study, and collected sequential 24 h urine samples from days 2-7 post partum. Potassium and oestrogen excretion were increased on day 3, and progesterone on days 3, 4 and 5. Differences in the excretion pattern of these hormones might reflect small changes in renal function and further work measuring plasma hormone levels could help to clarify this. PNH, like pre-menstrual headache and pill withdrawal headache may represent a further example of the triggering effect that a fall in sex hormone level has on the migraine diathesis.
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PMID:Headaches after childbirth. 671 Dec 73

The frequency and quality of headaches reported by 300 psychiatric patients were analyzed and compared to findings drawn from a general practice sample. Migraine and tension headaches were commonly reported and were found to be considerably more severe and frequent among psychiatric patients than among those patients attending a general practice. However, few of the psychiatric patients regarded their headaches as a major problem. Those who were headache sufferers had significantly higher scores on a psychometric assessment of neurotic tendency and were more frequently diagnosed as suffering from neurons than were those who reported few or no headaches. There was no association between headache and the diagnosis of depression, but psychometric scores on depression were significantly higher among the headache cases. The scale may have been reflecting general psychiatric distress rather than depression as such. The possibility that headaches contribute significantly to psychiatric distress, and are not merely a symptom of such distress, is considered.
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PMID:Headache in a psychiatric population. 705 84

The subjective component of headache pain has been neglected in headache research. In this study of 65 chronic headache sufferers, assessment of the subjective component was amplified using the McGill Pain Questionnaire (MPQ) as well as headache diaries. The overall level of pain experienced was as high as that previously reported for cancer and phantom-limb patients. Assessment of sensory pain qualities (MPQ) revealed differences between tension and migraine headache types; tension headaches were felt to be "tight", while migraines were experienced as "sharp", "blinding", "nauseating" and "sickening". The results thus support a dichotomous rather than a continuum model of headache. The relationship between the subjective experience of headache and mood (Wakefield Depression Scale) and personality (EPQ) was examined. Pain intensity and affective reactions to pain were associated with general mood state; however, no subjective measures correlated with personality indices. It was argued that the MPQ provided valuable additional information to be used with headache diaries, particularly in the assessment of sensory qualities and affective reactions to pain.
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PMID:The experience of headache pain--an assessment of the qualities of tension headache pain. 726 37

Subjects with tension-type headache and headache-free control subjects completed two mental stressor tasks, solving anagrams and mental arithmetic. During the experimental session, measures of heart rate, muscle tension, and subjective stress ratings were recorded. In addition, all subjects completed a week-long series of questionnaires which monitored headache activity in addition to frequency and intensity of stressful life events. Recurrent tension headache sufferers were found to have higher levels of depression and trait anxiety. Headache and control subjects were not found to respond differently to stressors presented in the laboratory based on measures of EMG, heart rate, or subjective stress ratings, nor were there differences in reports of coping. However, diary questionnaires revealed that headache subjects experienced stressful events more frequently than headache-free controls. Headache subjects also rated these events as causing more stress.
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PMID:Subjective stress and coping in recurrent tension-type headache. 759 37

Past epidemiological and clinical research has identified depression as the most common psychiatric disorder associated with headache. The present study carried out in a neurology headache clinic showed that the major associations were with current anxiety disorders, especially panic and related conditions. These findings were particularly true of the subgroup of migraine with aura; in the relatively few patients with mood disorders, depression was nearly always comorbid with panic or other anxiety disorders. Past history of depression was mainly a characteristic of the tension headache group. These data are compatible with the hypothesis that migraine, especially that with aura, panic disorder and some forms of depressive illness are part of the same spectrum.
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PMID:Headache, panic disorder and depression: comorbidity or a spectrum? 760 60

The authors investigate the appearance of psychogenic headaches among 150 displaced persons of both sexes, average age 43 years with specific prepared questionnaire (Incidental Report Interview with questions important for the culture of examinees), neurological and psychiatric checkups. Diagnosis of headache was established according to the criteria of the Headache Classification Committee of the International Headache Society. In the group of 150 displaced persons the authors have found 106 (70%), 31 (30%) among males and 75 (70%) among females) psychogenic headaches. Psychogenic headache appeared in 53% of the male cases and was connected with psychoticism (1.7%), conversion (8.3%) and depression (43%), and in 81% of the female cases expression of conversion (4.3%) or a follower of anxiety (10.7%) and depression (66%). Headache is together with anxiety and depression most frequently found in the age groups 31-40 and 51-60 years, among married individuals (76%), and among those with secondary school education (86%). In the group of psychogenic headaches, 13 (42%) males and 23 (30%) females had elements of muscle contraction (tension) headaches, and 9 (29%) males and 8 (10%) females, mainly from the groups 31-40 and 51-60 years with lower educational level had elements of combined vascular and tension headaches. There was a positive correlation between the employment before exile, unemployment in exile, the loss of experience in changing the place of living, leaving home and country under pressure and in peril of death and appearance and intensity of psychogenic headaches.
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PMID:[Headache in displaced persons from east Slavonia]. 771 8

Clinical and pharmacological data suggest a derangement of central monoaminergic systems in tension-type headache. Biochemical evidence has been rarely recognized. These findings may relate with pathophysiological mechanisms of headache or with underlying depression. We measured platelet-rich plasma serotonin and plasma catecholamines (norepinephrine, epinephrine, and dopamine) in 30 patients with tension-type headache and in 20 healthy controls, using High-Pressure Liquid Chromatography. We studied differences between groups and the relation between biochemical parameters and clinical indices evaluating duration and severity of headache and depression. Platelet serotonin levels in tension headache patients were higher than in controls (P < 0.001). Plasma catecholamine levels were lower in patients than in controls (P < 0.001 for epinephrine and dopamine, and P < 0.05 for norepinephrine). There was a positive correlation between dopamine levels and duration of history of headache (r = 0.55, P < 0.05). A negative correlation between epinephrine levels and severity of headache was observed (r = 51, P < 0.01). No correlations were found between monoamine levels and severity of depression. Our results add to the evidence of alterations of monoaminergic central systems in tension-type headache patients. These alterations seem to be independent from the underlying depression and related to the pathophysiologic mechanisms of headache.
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PMID:Plasma monoamines in tension-type headache. 800 28


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