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. 2010 Apr 11;11(3):247–253. doi: 10.1007/s10194-010-0208-1

Psychopathology and quality of life burden in chronic daily headache: influence of migraine symptoms

A Autret 1,✉, S Roux 2, S Rimbaux-Lepage 1, D Valade 3, S Debiais 1; the West Migraine Study Group
PMCID: PMC3451907  PMID: 20383733

Abstract

The aim of this study is to compare the psychopathology and the quality of life of chronic daily headache patients between those with migraine headache and those with tension-type headache. We enrolled 106 adults with chronic daily headache (CDH) who consulted for the first time in specialised centres. The patients were classified according to the IHS 2004 criteria and the propositions of the Headache Classification Committee (2006) with a computed algorithm: 8 had chronic migraine (without medication overuse), 18 had chronic tension-type headache (without medication overuse), 80 had medication overuse headache and among them, 43 fulfilled the criteria for the sub-group of migraine (m) MOH, and 37 the subgroup for tension-type (tt) MOH. We tested five variables: MADRS global score, HAMA psychic and somatic sub-scales, SF-36 psychic, and somatic summary components. We compared patients with migraine symptoms (CM and mMOH) to those with tension-type symptoms (CTTH and ttMOH) and neutralised pain intensity with an ANCOVA which is a priori higher in the migraine group. We failed to find any difference between migraine and tension-type groups in the MADRS global score, the HAMA psychological sub-score and the SF36 physical component summary. The HAMA somatic anxiety subscale was higher in the migraine group than in the tension-type group (F(1,103) = 10.10, p = 0.001). The SF36 mental component summary was significantly worse in the migraine as compared with the tension-type subgroup (F(1,103) = 5.758, p = 0.018). In the four CDH subgroups, all the SF36 dimension scores except one (Physical Functioning) showed a more than 20 point difference from those seen in the adjusted historical controls. Furthermore, two sub-scores were significantly more affected in the migraine group as compared to the tension-type group, the physical health bodily pain (F(1,103) = 4.51, p = 0.036) and the mental health (F(1,103) = 8.17, p = 0.005). Considering that the statistic procedure neutralises the pain intensity factor, our data suggest a particular vulnerability to somatic symptoms and a special predisposition to develop negative pain affect in migraine patients in comparison to tension-type patients.

Keywords: Psychopathology, Quality of life, Chronic daily headache, Migraine symptoms, Tension type headache symptoms

Full Text

The Full Text of this article is available as a PDF (165.8 KB).

Acknowledgments

This study was sponsored by Astra Zeneca France.

Glossary

CDH

Chronic daily headache

IHS

International Headache Society

ICHD-II

International Classification of Headache Disorders-II

CTTH

Chronic tension type headache

CM

Chronic migraine

MOH

Medication overuse headache

PM

Probable migraine

TTH

Tension type headache

BMI

Body mass index

MADRS

Montgomery and Asberg depression scale

HAMA

Hamilton anxiety

SF-36

MOS 36-item short-form health survey (SF-36)

PF

Physical functioning

RP

Role physical

BP

Bodily pain

GH

General health perception

VT

Vitality

SF

Social functioning

RE

Role emotional

MH

Mental health

Appendix

Allain H, Hinault P, Rennes; Bellard S, Goas JY, Brest; de Bray JM, Dubas F, Verny C, Angers; Feve JM, Magne C, Vercelletto M, Nantes; Merienne JM, Saint Malo; Neau JP, Poitiers; Pinel JF, Rennes; Pouyet A, Saint Brieuc; Schuermans P, La Rochelle; Verret JM, Le Mans.

Footnotes

The members of the West Migraine Study Group are given in the Appendix.

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