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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atypical facial pain is generally an unclearly defined pain syndrome. We tested in 35 patients (31 women, 4 men) with a mean age of 53.2 +/- 14.9 years and a chronic facial pain syndrome the quality of the new diagnostic criteria of the International Headache Society (IHS), at the same time using the SCL-90-R (Self-Report Symptom Inventory), to identify any associated psychopathology. In accordance with the literature there is a marked female preponderance, an altogether vague description of symptoms and a long history of incorrect diagnoses. Of note is the high number of invasive procedures (3.5 +/- 3.0). In agreement with the IHS commentary, an operation or injury to the face was a suspected cause in 43%. In contrast to the IHS criteria, we found in our patient sample dysaesthesia (63%), bilateral occurrence (37%), remission periods (57%), pain attacks (23%) and presence of superficial as well as deep pain. Depression is by no means the only psychopathological abnormality in atypical facial pain; a broad spectrum of complaints is seen. The IHS classification appears insufficient to separate atypical facial pain from other primary headache and facial pain syndromes. We therefore suggest a modified version of the IHS criteria for atypical facial pain.
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PMID:[Atypical facial pain--quality of IHS (International Headache Society) criteria and psychometric data]. 143 49

Pain patients' retrospective reports of pain are important to physicians and other health professionals in helping to decide on future treatment plans. Unfortunately patients' memory of pain can be inaccurate and subject to overestimation. This study examined variables which influenced accuracy of remembering pain in 93 chronic pain patients. The patients were initially evaluated by a physician and completed a comprehensive pain questionnaire and an SCL-90. All patients were asked to monitor their pain intensity every hour for 1 week. At the end of this period each patient was asked to estimate their average pain intensity ratings for 4 times during the day for the previous week. These estimations were compared with the actual mean pain ratings. Results showed that most patients tended to overestimate their pain intensity levels. Cervical and low back pain patients were found to be more accurate than headache and abdominal pain patients in remembering their pain. Patients who reported more emotional distress, who had conflicts at home, who were less active and who relied on medication tended to be the most inaccurate in remembering their pain.
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PMID:The influence of physical and psychosocial factors on accuracy of memory for pain in chronic pain patients. 275 10

From the literature, it is clear that a small proportion of people account for an inordinately high number of health care visits. Conversely, there exists a group of individuals who rarely seek professional medical intervention and, yet, who remain healthy. This study examines a sample of adults who have not received remedial treatment for any symptom in the previous year, who consider themselves as healthy and who pass a comprehensive physical examination. A gender and age balanced group of healthy low utilizers was administered the Symptom Response Questionnaire, an instrument designed to elicit response tendencies to thirteen standardized symptoms. There were significant differences between age groups in response to symptoms with the older individuals more likely to seek professional help. There were few gender differences within the healthy sample. This sample of healthy low-utilizers was not without symptoms, reporting an average of 20 symptoms occurring in the previous week as measured by the SCL-90. A clinical headache group was also administered the SRQ to provide information about their response tendencies to symptoms. This preliminary study suggests that response to illness may be significantly influenced by age and patient status and that reported gender differences in health care utilization may need to be examined more carefully. It is proposed that behavior patterns of healthy, low utilizers may have direct implications for intervention with high utilizers of the health care system.
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PMID:Response to symptoms in healthy, low utilizers of the health care system. 382 Jan 38

The aims of this study were to (a) investigate the efficacy of autogenic training (AT) and cognitive self-hypnosis training (CSH) for the treatment of chronic headaches in comparison with a waiting-list control (WLC) condition, (b) investigate the influence of subject recruitment on treatment outcome and (c) explore whether the level of hypnotizability is related to therapy outcome. Three different subjects groups (group 1, patients (n = 58) who were referred by a neurological outpatient clinic; group 2, members (n = 48) of the community who responded to an advertisement in a newspaper; and group 3, students (n = 40) who responded to an advertisement in a university newspaper) were allocated at random to a therapy or WLC condition. During treatment, there was a significant reduction in the Headache Index scores of the subjects in contrast with the controls. At post-treatment and follow-up almost no significant differences were observed between the 2 treatment conditions or the 3 referral sources regarding the Headache Index, psychological distress (SCL-90) scores and medication use. Follow-up measurements indicated that therapeutic improvement was maintained. In both treatment conditions, the high-hypnotizable subjects achieved a greater reduction in headache pain at post-treatment and follow-up than did the low-hypnotizable subjects. It is concluded that a relatively simple and highly structured relaxation technique for the treatment of chronic headache subjects may be preferable to more complex cognitive hypnotherapeutic procedures, irrespective of the source of recruitment. The level of hypnotic susceptibility seems to be a subject characteristic which is associated with a more favourable outcome in subjects treated with AT or CSH.
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PMID:Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups. 783 82

Suspected postprandial (reactive or idiopathic) hypoglycemia is characterized by predominantly adrenergic symptoms appearing after meals rich in carbohydrates and by their rare association with low blood glucose level (< 2.77 mmol/L). We studied heart rate, blood pressure, plasma insulin, C-peptide, and catecholamine responses during a 5-h oral glucose tolerance test in eight patients with suspected postprandial hypoglycemia and eight age-, sex-, and body mass index-matched healthy controls. We also evaluated beta-adrenergic sensitivity by using the isoproterenol sensitivity test. Psychological profile was assessed by the Symptom Checklist (SCL-90R) self-report symptom inventory. Patients with suspected postprandial hypoglycemia had higher beta-adrenergic sensitivity (defined as the dose of isoproterenol required to increase the resting heart rate by 25 beats/min) than controls (mean +/- SEM, 0.8 +/- 0.13 vs. 1.86 +/- 0.25 microgram isoproterenol; P = 0.002). After administration of glucose (75 g) blood glucose, plasma C-peptide, plasma epinephrine, and plasma norepinephrine responses were identical in the two groups, but plasma insulin was higher in the patients (group effect, P = 0.02; group by time interaction, P = 0.0001). Both heart rate and systolic blood pressure were significantly higher (but remained in the normal range) after glucose administration in patients with suspected postprandial hypoglycemia than in controls (group by time interactions, P = 0.004 and 0.0007, respectively). After glucose intake, seven patients had symptoms (palpitations, headache, tremor, generalized sweating, hunger, dizziness, sweating of the palms, flush, nausea, and fatigue), whereas in the control group, one subject reported flush and another palpitations, tremor, and hunger. Analysis of the SCL-90R questionnaire revealed that patients had emotional distress and significantly higher anxiety, somatization, depression, and obsessive-compulsive scores than controls. We may conclude that patients with suspected postprandial hypoglycemia have normal glucose tolerance, increased beta-adrenergic sensitivity, and emotional distress.
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PMID:Suspected postprandial hypoglycemia is associated with beta-adrenergic hypersensitivity and emotional distress. 796 39

The levels of N-acetyl-beta-glucosaminidase (NAG) in urine from 35 patients with bipolar affective disorder were compared with scores for the 90 items (symptoms) of the Symptom Checklist (SCL-90). There were significant negative correlations between NAG levels and 23 of the SCL-90 variables (symptoms). These symptoms could be grouped into the following categories: anxiety, unusual or psychotic thinking, suicidal thinking, dysphoria, irritability, nausea, headaches, memory problems, and loss of interest. Serotonin abnormalities may play a role in the production of many of these symptoms. The hypothesis that NAG could be a marker for a serotonin activity is discussed.
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PMID:Association of levels of N-acetyl-beta-glucosaminidase with specific psychiatric symptoms in bipolar patients. 834 66

The present study investigated the association between personality, symptoms and headache subtypes in a prospective longitudinal epidemiologic study of a cohort of 19- and 20-year-olds in Zurich, Switzerland. Personality was assessed by the Freiburg Personality Inventory (FPI), a standardized self-report personality instrument, which yields nine primary factors and three secondary factors. The Symptom Checklist 90 (SCL-90) was employed to examine somatic and psychological symptoms. Subjects with migraine exhibited elevated rates of neuroticism compared to non-migraine subjects on FPI. Somatization was the only primary symptom factor on the SCL-90 which discriminated between subjects with migraine and those without migraine. Persons with migraine with aura exhibited greater impairment than any of the other headache subtypes or controls on both the FPI and SCL-90. Subjects with tension-type headache did not differ from controls on any of the personality or symptom factors.
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PMID:Headache and personality: results of a community sample of young adults. 836 68

Headache often compounds chronic neck pain following whiplash injury. To better understand post-traumatic headache, the SCL-90-R symptom checklist was used to determine the psychological profiles of patients with whiplash-associated headache and of patients with whiplash-associated neck pain without headache. The psychological profiles of these patients were compared with previously published SCL-90-R profiles of patients with post-traumatic and nontraumatic headache, and of the normal population. Patients with whiplash-associated headache were not significantly different from those with other forms of post-traumatic headache or with whiplash-associated neck pain without headache. However, when patients with whiplash-associated headache and patients with nontraumatic headache were compared to normal data, significant differences emerged. Patients with nontraumatic headache exhibited higher scores on all subscales, whereas patients with whiplash-associated headache differed from the normal sample only on somatization, obsessive-compulsive, depression and hostility subscales, and the global severity index. These differences imply that patients with whiplash-associated headache suffer psychological distress secondary to chronic pain and not from tension headache and generalized psychological distress.
Cephalalgia 1998 Mar
PMID:The psychological profiles of patients with whiplash-associated headache. 982 54

The aim of this study was to compare somatic complaints and psychologic distress in a group of whiplash patients with temporomandibular disorders (TMD) and a group of patients with TMD only, and to assess the outcome after conservative TMD treatment consisting of counseling, muscle exercises, and a stabilization splint. Each group consisted of 16 patients (12 women and 4 men) with a mean age of 42 years. The duration of the symptoms was from 1 to 3 years. In addition to a functional clinical examination and a recording of headache frequency and intensity, the patients answered three questionnaires: a Somatic Complaints Questionnaire (SCQ); the trait portion of Spielberger's State-Trait Anxiety Inventory; and the Symptom Checklist-90-Revised (SCL-90-R). The whiplash patients had higher scores than the TMD patients on the SCQ muscle score and on the following subscores of SCL-90-R: obsession, somatization, depression, and anger/hostility. The treatment outcome as assessed by the change of self-reported frequency of headache, number of tender muscles upon palpation, and change of values on a visual analogue scale for headache intensity showed that the whiplash patients obtained only a decrease in the proportion of tender muscles, while those in the TMD only group showed improvement on all treatment criteria.
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PMID:Somatic complaints, psychologic distress, and treatment outcome in two groups of TMD patients, one previously subjected to whiplash injury. 965 91

There were examined 35 patients with panic disorders (PD) which were divided into 2 groups. In patients of the 1-st group there were observed headaches of tension type (17 individuals), meanwhile in the patients of the 2-nd group (18 cases) there weren't observed any algesic syndromes. A "saturation" of the life of a patient with the different algesic phenomena were estimated as well as the level of a depression according to Beck's scale and the manifestations of psychopathologic symptoms according to SCL scale were also studied. To estimate neurophysiologic parameters there were used a method of a contingent negative deviation (CND) and nociceptive flexor reflex. For the patients of the 1-st group there was quite characteristic a "saturation" of life with algesic events, an atypicity of the algesic attacks and more pronounced connection of PD debut with biologic but not with emotional factors. Psychometric observation revealed a significantly higher levels of both the depression according to Beck's and the somatization according to SCL scales as compared with the 2-nd group. Alterations in CND parameters (a decrease of the amplitude of the late wave, increase of postimperative negative wave) and an increase of a subjective algesic perception in the patients of the 1-st group had testified the pronounced desadaptive disorders. In the patients of the 2-nd group these indices were normal. Thus, on the PD model there were studied some psychophysiologic factors, which caused a formation of chronic algesic syndromes in the patients.
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PMID:[Algesic phenomena in panic disorders]. 1057 26


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