RESUMEN
INTRODUCTION: Although it is known that anxiety and depressive disorders frequently accompany migraine and TTH, the role of somatic amplification (SSA) and health anxiety in these diseases is not adequately known. OBJECTIVE: The aim of this study is to compare SSA and health anxiety in patients with migraine or TTH, and healthy controls and to investigate the relationships between SSA, health anxiety, headache characteristics, anxiety and depressive symptoms. METHODS: Fifty-four migraine, 50 TTH patients from the outpatient unit of the neurology department and 53 healthy volunteers were recruited for the study. The somatosensory amplification scale (SSAS), health anxiety inventory, Beck depression (BDI) and anxiety inventory (BAI) were administered to all participants. RESULTS: The SSAS scores were significantly higher in migraineurs compared with the healthy controls. The health anxiety scores were significantly higher in both migraine and TTH groups. The BDI and BAI scores were also significantly higher in migraine and TTH groups compared with the controls. A significant positive correlation was found between headache frequency and BAI scores, the visual analogue scale scores and SSAS and BDI scores in migraineurs. The SSAS scores were also significantly correlated with the BDI and BAI scores in both of the headache groups. A similar correlation was determined with the health anxiety scores. CONCLUSIONS: While patients with migraine and TTH evalute, taking into account the SSA and health anxiety may contribute to the prognosis and treatment of these diseases.
Asunto(s)
Trastornos de Ansiedad/psicología , Trastornos Migrañosos/psicología , Trastornos Somatosensoriales/psicología , Cefalea de Tipo Tensional/psicología , Adolescente , Adulto , Análisis de Varianza , Estudios de Casos y Controles , Niño , Estudios Transversales , Trastorno Depresivo/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Escalas de Valoración Psiquiátrica , Valores de Referencia , Autoinforme , Índice de Severidad de la Enfermedad , Factores Socioeconómicos , Estadísticas no Paramétricas , Adulto JovenRESUMEN
ABSTRACT Although it is known that anxiety and depressive disorders frequently accompany migraine and TTH, the role of somatic amplification (SSA) and health anxiety in these diseases is not adequately known. Objective: The aim of this study is to compare SSA and health anxiety in patients with migraine or TTH, and healthy controls and to investigate the relationships between SSA, health anxiety, headache characteristics, anxiety and depressive symptoms. Methods: Fifty-four migraine, 50 TTH patients from the outpatient unit of the neurology department and 53 healthy volunteers were recruited for the study. The somatosensory amplification scale (SSAS), health anxiety inventory, Beck depression (BDI) and anxiety inventory (BAI) were administered to all participants. Results: The SSAS scores were significantly higher in migraineurs compared with the healthy controls. The health anxiety scores were significantly higher in both migraine and TTH groups. The BDI and BAI scores were also significantly higher in migraine and TTH groups compared with the controls. A significant positive correlation was found between headache frequency and BAI scores, the visual analogue scale scores and SSAS and BDI scores in migraineurs. The SSAS scores were also significantly correlated with the BDI and BAI scores in both of the headache groups. A similar correlation was determined with the health anxiety scores. Conclusions: While patients with migraine and TTH evalute, taking into account the SSA and health anxiety may contribute to the prognosis and treatment of these diseases.
RESUMO Embora se saiba que os distúrbios de ansiedade e depressão frequentemente acompanhem a enxaqueca e a TTH, o papel da amplificação somatossensorial (somatosensory amplification, SSA) e da hipocondria nessas doenças ainda não é bem conhecido. Objetivo: O presente estudo faz uma comparação entre pacientes que sofrem de enxaqueca e TTH com um grupo de controle saudável em termos de SSA e hipocondria e investiga a relação entre os achados e as características da cefaleia, a ansiedade e os sintomas depressivos. Métodos: O estudo incluiu 54 pacientes com enxaqueca, 50 pacientes com TTH e 53 voluntários saudáveis que se cadastraram na clínica de neurologia. A escala de amplificação somatossensorial (somatosensory amplification scale, SSAS), o inventário de hipocondria, o Inventário de Depressão de Beck (Beck Depression Inventory, BDI) e o Inventário de Ansiedade de Beck (Beck Anxiety Inventory, BAI) foram aplicados aos participantes. Resultados: Quando comparados com os controles saudáveis, as pontuações da SSAS dos pacientes com enxaqueca foram significativamente maiores, enquanto as pontuações de hipocondria foram significativamente maiores em ambos os grupos de enxaqueca e TTH. As pontuações do BAI e do BDI foram significativamente maiores em ambos os grupos de pacientes que no grupo de controle. No grupo da enxaqueca, foi identificada uma correlação positiva entre frequência de cefaleia e ansiedade, bem como entre a Escala Analógica Visual (EVA), a SSAS e a depressão. Em ambos os grupos de pacientes, a SSA foi correlacionada positivamente com a depressão e a ansiedade, e uma correlação semelhante foi encontrada entre a SSA e a hipocondria. Conclusão: Em avaliações dessas doenças, a hipocondria e a SSA devem ser levadas em consideração, pois se acredita que essa abordagem possa contribuir positivamente para o prognóstico e tratamento da doença.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Trastornos de Ansiedad/psicología , Cefalea de Tipo Tensional/psicología , Trastornos Somatosensoriales/psicología , Trastornos Migrañosos/psicología , Escalas de Valoración Psiquiátrica , Valores de Referencia , Factores Socioeconómicos , Índice de Severidad de la Enfermedad , Dimensión del Dolor , Estudios de Casos y Controles , Estudios Transversales , Análisis de Varianza , Estadísticas no Paramétricas , Trastorno Depresivo/psicología , AutoinformeRESUMEN
Fibromyalgia and tensional headache are two of the most prevalent functional disorders. Both seem to imply relationships with processes of the psychopathological sphere. However, they have been little studied since Psychiatry. This descriptive observational research work, with a consulting population of the Hospital "T. Álvarez" in the city of Buenos Aires, Argentina, focuses on certain psychiatric and psychological variables chosen for this purpose. The results are compared with those of a sample of patients diagnosed with Undifferentiated Somatoform Disorder, from the Mental Health service. The investigation showed affectation of different variables (Ham A, Ham D, subscale of somatization of SCL 90 and clinical scales of the MMPI II test). The existence of regularities was observed through the three groups of patients in the aforementioned variables. The existence of a certain common psychometric profile is hypothesized, both for the two functional medical tables and for the somatizing patients of the Mental Health sample.
Asunto(s)
Fibromialgia , Trastornos Somatomorfos , Cefalea de Tipo Tensional , Argentina , Fibromialgia/psicología , Humanos , Trastornos Somatomorfos/psicología , Cefalea de Tipo Tensional/psicologíaRESUMEN
Introdução: A cefaleia é uma afecção que impacta negativamente a qualidade de vida da pessoa. O curso de medicina é reconhecidamente um gerador de esgotamento e, de acordo com a literatura, fatores estressantes são mais comuns em alunos de medicina que na população em geral, podendo desencadear a cefaleia. Esses fatores estressores podem ser intensificados em períodos que antecedem as provas devido a mudanças nos hábitos de sono e de estudo, havendo uma possível relação com o surgimento de cefaleias primárias. Objetivo: Avaliar a prevalência de cefaleia primária nos estudantes de medicina (EM) em períodos de provas e relacionar com fatores psicossociais. Métodos: Trata-se de um estudo transversal, baseado na aplicação de dois questionários a uma amostra de 219 EM do 1º ao 8º semestre de uma universidade no interior do Ceará. Um questionário relacionou a cefaleia com fatores psicossociais em períodos de provas. O segundo questionário: HSQ-DV, foi utilizado para o diagnóstico de enxaqueca e cefaleia do tipo tensional (CTT). Resultados: 98% dos EM relataram já ter sentido cefaleia. A prevalência de CTT e enxaqueca encontradas foi de 61,9% e 18,1%, respectivamente, dados maiores que a média para a população geral. Estudantes com enxaqueca têm mais crises antes de provas, se automedicam mais, ingerem mais psicoestimulantes, são mais ansiosos, mais depressivos, mais sedentários, mais estressados e dormem menos que aqueles com CTT. Conclusão: De fato, os EM são um grupo de risco para o desenvolvimento de cefaleias, merecendo, portanto, uma maior ênfase de pesquisas científicas sobre as cefaleias primárias neste grupo.
Introduction: Headache is a condition that impacts negatively the patients' quality of life. The medical course is a known generator of exhaustion and, according to the literature, stressors are more common in medical students (MS) than in the general population, which can trigger a headache. These stressors can be intensified in periods that precede the tests due to changes in sleep and in study habits, with a possible relation with the appearance of primary headache. Objective: To associate the presence of primary headache in MS during periods of tests and to relate to psychosocial factors. Methods: This is a cross-sectional study based on the application of two questionnaires to a sample of 219 MS from the 1st to the 8th semester of a university in Northeast Brazil. The first questionnaire related headache with psychosocial factors in periods of tests. The second questionnaire: HSQ-DV, was used for the diagnosis of migraine and tension-type headache (TTH). Results: 98% of MS reported having experienced headache. The prevalence of TTH and migraine was 61.9% and 18.1%, respectively, higher than the average for the general population. Students with migraine have more attacks before tests, self-medicate more, ingest more psychostimulants, are more anxious, more depressed, more sedentary, more stressed, and sleep less than those with TTH. Conclusion: In fact, MS are a risk group for the development of headache, thus deserving a greater emphasis of scientific research on primary headaches in this group
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Automedicación , Estudiantes de Medicina/psicología , Cefalea de Tipo Tensional/psicología , Impacto Psicosocial , Cefaleas Primarias/psicología , Cefalea/epidemiología , Trastornos Migrañosos/psicologíaRESUMEN
OBJECTIVE: To describe patterns of psychosocial adjustment and psychological attributes in preadolescent children as a function of headache status in univariate and adjusted analyses. METHODS: Target sample of children (n = 8599) was representative of Brazil by demographics. Parents were interviewed using validated headache questionnaires and the "Strengths and Difficulties Questionnaire," which measures behavior in 5 domains. One-year prevalence estimates of headaches were derived by demographics. Relative risk of abnormal Strengths and Difficulties Questionnaire scores were separately modeled in children with episodic migraine and episodic tension-type headache using logistic regression. RESULTS: Sample consisted of 5671 children (65.9% of the target sample), from 5 to 12 years old (49.3% girls). Prevalence estimates in children were 20.6% for "no headache," 9% for episodic migraine, and 12.8% for episodic tension-type headache. Abnormal scores in psychosocial adjustment were significantly more likely in children with episodic migraine, relative to children without headaches and children with episodic tension-type headache, and was significantly influenced by frequency of headache attacks, nausea, school performance, prenatal exposure to tobacco, as well as by phonophobia and photophobia. CONCLUSIONS: Children with migraine are at an increased risk of having impairment in psychosocial adjustment, and the factors associated with this impairment have been mapped. Future studies should address the directionality of the association and putative mechanisms to explain it.
Asunto(s)
Trastornos Mentales/epidemiología , Trastornos Migrañosos/epidemiología , Trastornos Migrañosos/psicología , Ajuste Social , Cefalea de Tipo Tensional/epidemiología , Cefalea de Tipo Tensional/psicología , Distribución por Edad , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Masculino , Distribución por SexoRESUMEN
PURPOSE: The purpose of this study was to evaluate the presence of signs and symptoms of temporomandibular disorders (TMD) in children with headaches in a neuropediatric ambulatory. METHOD: Fifty patients between 4 and 18 years of age were examined: 31 had headaches (24 migraine, 4 tension type and 3 unspecific headache) and 19 formed the control group. The data collection was comprised of a structured questionnaire answered by the children's parents, and a subjective evaluation about the childrens emotional state. A specific questionnaire for TMD was applied, followed by a clinical dental examination of the children. As signs of TMD, mouth opening limitation, mandibular trajectory deviation in opening mouth, and joint noise were considered. As symptoms, pain on palpation of masseter and temporal muscles and on the poromandibular joint. RESULTS: A significant increase in signs and symptoms of TMD was found in patients with headaches when compared to the control group. There was also a significant difference in signs and symptoms of TMD according to age (increased with age) and emotional state (tense>calm). CONCLUSION: There is a higher frequency of TMD in pediatric patients with headaches; thus, it is important to look for TMD signs and symptoms in this population.
Asunto(s)
Emociones , Trastornos de Cefalalgia/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico , Adolescente , Factores de Edad , Estudios de Casos y Controles , Niño , Conducta Infantil/fisiología , Conducta Infantil/psicología , Preescolar , Dolor Facial/fisiopatología , Femenino , Trastornos de Cefalalgia/psicología , Humanos , Masculino , Músculos Masticadores/fisiopatología , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/psicología , Distribución por Sexo , Factores Sexuales , Articulación Temporomandibular/fisiopatología , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/fisiopatología , Cefalea de Tipo Tensional/diagnóstico , Cefalea de Tipo Tensional/psicologíaRESUMEN
PURPOSE: The purpose of this study was to evaluate the presence of signs and symptoms of temporomandibular disorders (TMD) in children with headaches in a neuropediatric ambulatory. METHOD: Fifty patients between 4 and 18 years of age were examined: 31 had headaches (24 migraine, 4 tension type and 3 unspecific headache) and 19 formed the control group. The data collection was comprised of a structured questionnaire answered by the children's parents, and a subjective evaluation about the childrenÆs emotional state. A specific questionnaire for TMD was applied, followed by a clinical dental examination of the children. As signs of TMD, mouth opening limitation, mandibular trajectory deviation in opening mouth, and joint noise were considered. As symptoms, pain on palpation of masseter and temporal muscles and on the poromandibular joint. RESULTS: A significant increase in signs and symptoms of TMD was found in patients with headaches when compared to the control group. There was also a significant difference in signs and symptoms of TMD according to age (increased with age) and emotional state (tense> calm). CONCLUSION: There is a higher frequency of TMD in pediatric patients with headaches; thus, it is important to look for TMD signs and symptoms in this population.
OBJETIVO: Avaliar a presença de sinais e sintomas de disfunção temporomandibular (DTM) em crianças com cefaléias em um ambulatório de neuropediatria. MÉTODO: Foram examinados 50 pacientes com idade entre 4 e 18 anos, 31 com cefaléias (24 com enxaqueca, 4 com cefaléia tensional e 3 com cefaléia inespecífica) e 19 do grupo controle. Os dados compreenderam um questionário estruturado respondido pelos pais e uma avaliação subjetiva sobre o estado emocional das crianças. Foi aplicado um questionário específico para DTM e realizado um exame clínico dental. Foram considerados como sinais de DTM: limitação da abertura bucal, desvio da trajetória ao abrir a boca e ruído articular. Quanto aos sintomas, foram considerados: dor à palpação dos músculos masseter e temporal e na articulação temporomandibular. RESULTADOS: Foi encontrado um aumento significante de sinais e sintomas de DTM em pacientes com cefaléias quando comparados com o grupo controle. Houve, também, uma diferença significante de sinais e sintomas de DTM de acordo com a idade (aumento com a idade) e estado emocional (tenso>calmo). CONCLUSÃO: Há maior freqüência de sinais e sintomas de DTM no grupo de pacientes pediátricos com cefaléias, sendo importante avaliar essa patologia nessa população.
Asunto(s)
Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Emociones , Trastornos de Cefalalgia/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico , Factores de Edad , Estudios de Casos y Controles , Conducta Infantil/fisiología , Conducta Infantil/psicología , Dolor Facial/fisiopatología , Trastornos de Cefalalgia/psicología , Músculos Masticadores/fisiopatología , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/psicología , Distribución por Sexo , Factores Sexuales , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/fisiopatología , Articulación Temporomandibular/fisiopatología , Cefalea de Tipo Tensional/diagnóstico , Cefalea de Tipo Tensional/psicologíaRESUMEN
OBJECTIVE: To evaluate the impact of ETTH on HRQoL in a sample of employees of a Brazilian public hospital. METHOD: Three hundred and sixty Mário Gatti Hospital employees were asked about headache occurrence in the previous 6 months and completed a SF-36 and a pain questionnaires concerning impact of pain (0 to 10 scale) on daily activities, work efficiency, leisure and social activities in previous six months. Two groups were studied: 1. Episodic Tension-type headache group: 127 employees -- 81 (63.8%) female and 46 (36.2%), male. 2. CONTROL GROUP: 124, 71 (57.3%) female and 53 (42.7%) male. RESULTS: ETTH had lowers scores than control in all domains of SF-36; in vitality and bodily pain the difference was statistically significant. CONCLUSION: Our results indicate that ETTH suffers have impact on HRQoL predominantly in vitality. Psychological factors associated to pain may explain this finding.
Asunto(s)
Personal de Salud , Calidad de Vida , Cefalea de Tipo Tensional/psicología , Brasil , Estudios de Casos y Controles , Femenino , Hospitales Públicos , Humanos , Masculino , Dimensión del Dolor , Encuestas y CuestionariosRESUMEN
OBJETIVO: Avaliar o Impacto de CTTE na QVRS em funcionários de um hospital brasileiro. MÉTODO: Trezentos e sessenta empregados do Hospital Mário Gatti, foram entrevistados. O questionário para avaliação da QVRS SF-36 foi aplicado e a ocorrência de cefaléia nos últimos seis meses foi avaliada. O impacto da dor nas atividades diárias, de lazer, sociais e eficiência no trabalho foi estimado(escala de zero a dez). RESULTADOS: Foram estudados dois grupos: 1. Cefaléia do tipo tensional episódica: 127 empregados - 81 (63,8%) mulheres e 46 (36,2%), homens. 2. Grupo Controle: 124 funcionários, 71 (57,3%) mulheres e 53 (42,7%) homens. As médias do grupo CTTE foram menores que as do grupo controle nos oito aspectos avaliados pelo SF-36. Nos aspectos vitalidade e dor a diferença foi estatisticamente significativa. CONCLUSÃO: os indivíduos com CTTE apresentaram pior QVRS, predominantemente no aspecto vitalidade. É possível que fatores psicológicos associados à dor possam explicar este achado.
Asunto(s)
Femenino , Humanos , Masculino , Personal de Salud , Calidad de Vida , Cefalea de Tipo Tensional/psicología , Brasil , Estudios de Casos y Controles , Hospitales Públicos , Dimensión del Dolor , Encuestas y CuestionariosRESUMEN
BACKGROUND: Tension-type headache (TTH) is recognized as the most prevalent type of headache. Despite this, there is a limited understanding of the entity's physiology, epidemiology, and clinical presentation. Anxiety and depression are recognized comorbidities present among patients with TTH. OBJECTIVE: To quantify the prevalence of anxiety and depression among patients with episodic and chronic TTH. METHOD: fifty patients with episodic TTH and fifty patients with chronic TTH completed Beck's anxiety and depression surveys. Only patients presenting with moderate to severe scores were considered. RESULTS: among the patients with episodic TTH, anxiety and depression were observed in 30 (60%) and 16 (32%) patients respectively. Among the patients with chronic TTH, anxiety was observed in 22 (44%) patients, and depression was observed in 20 (40%). CONCLUSION: both comorbidities are important among patients with episodic and chronic TTH. Neglecting this association may result in failure of symptomatic and prophylactic treatment ultimately leading to lost quality of life.
Asunto(s)
Depresión/etiología , Cefalea de Tipo Tensional/psicología , Adolescente , Adulto , Ansiedad/epidemiología , Ansiedad/psicología , Brasil/epidemiología , Niño , Enfermedad Crónica , Comorbilidad , Depresión/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cefalea de Tipo Tensional/epidemiologíaRESUMEN
OBJECTIVE: To determine the prevalence of migraine and episodic tension-type headache (ETTH) among university students as well as its impact on academic performance and quality of life. BACKGROUND: Headache is a very common symptom in clinical practice. The reduced capacities due to migraine can be profound, and more studies are needed to evaluate, in particular, school performance. Few studies have been conducted to evaluate the impact of tension-type headache on work productivity, quality of life, and the impact of headache on school performance. METHODS: A total of 1022 students were interviewed. Two questionnaires were utilized, a standard one that permitted a diagnosis of migraine or ETTH according to the criteria of the International Headache Society and a second one consisting of a battery of tests on quality of life. RESULTS: A total of 256 students (25%) had migraine and 336 (32.9%) reported ETTH. When in pain, migraineurs demonstrated a 62.7% decrease in productivity while studying, compared with a 24.4% decrease in those with ETTH. Fifty percent of migraineurs tried to study despite the pain, compared with 53.2% of those with ETTH. With respect to all other items tested, there was a significantly higher impairment in the presence of migraine than in the presence of ETTH and in the presence of the latter compared with a control situation. CONCLUSIONS: The present study confirms the profound impact of headache on the performance of university students, with this impact much more evident among migraineurs but also important among students with ETTH.
Asunto(s)
Logro , Trastornos Migrañosos/fisiopatología , Trastornos Migrañosos/psicología , Calidad de Vida , Estudiantes , Cefalea de Tipo Tensional/fisiopatología , Cefalea de Tipo Tensional/psicología , Adulto , Femenino , Humanos , MasculinoRESUMEN
INTRODUCTION: Tension-type headache (TTH) is the commonest head pain to be seen in medical practice and is erroneously thought to have a psychogenic origin. OBJECTIVE: To evaluate the presence of depression in a cohort of persons with TTH and compare them with patients with migraine and with a control group. The clinical characteristics of patients with TTH were also noted. PATIENTS AND METHODS: We studied 89 patients with chronic TTH. Their level of depression (on the Hamilton scale) was compared with 31 patients with migraine with typical aura and a control group of 34 asymptomatic volunteers, matched for age, marital and job status. RESULTS: No difference was observed in the index of depression of the group of patients with chronic TTH as compared with the control group with migraine: p < 0.9412 and OR 1.07. Compared with the asymptomatic control group: p < 0.0272 and OR 3.81, which are significant figures. After 11 months of prophylactic treatment with imipramine (50 mg/day), levels of depression persisted in 20.02% of the patients, p < 0.06319 and OR 2.01 even when treatment was optimum in 98.8%. CONCLUSIONS: Patients with chronic TTH showed indices of depression in 33.7%. This figure was similar in those with migraine, 32.2%. Also response to treatment was independent of this figure. In 48% of the patients there was fear of having cerebral vascular disease.