Patients with chronic headache tend to have more
                    psychological symptoms than those with sporadic episodes of pain

Zampieri, Maria Aparecida Junqueira; Tognola, Waldir Antonio; Galego, José Carlos Busto

doi:10.1590/0004-282X20140084

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Sumário

Articles • Arq. Neuro-Psiquiatr. 72 (8) • Aug 2014 • https://doi.org/10.1590/0004-282X20140084 copy

Patients with chronic headache tend to have more psychological symptoms than those with sporadic episodes of pain

Pacientes com cefaleia crônica tendem a ter mais sintomas psicológicos que aqueles com episódios esporádicos de dor

Authorship SCIMAGO INSTITUTIONS RANKINGS

There are controversial associations between headaches and psychological symptoms.

Objective

To design a profile of neuroticism, a term that groups variables related to negative personality traits, in patients with chronic daily headache (CDH) when compared to episodic migraine (EM) patients, applying the Factorial Scale of Emotional Adjustment/Neuroticism (NFS).

Method

One hundred adult patients with CDH and forty with EM answered the NFS.

Results

Comorbidities of subtypes of neuroticism (p=0.006) were more common in chronic daily headache patients, with three or more disorders (p=0.0002): dependent personality disorder (p=0.0001), anxiety, reduced concentration and production (p=0.0008), depression (p<0.0001), suicidal ideation (p=0.0008) and hopelessness even without depression (p<0.0001).

Conclusion

Patients with CDH tend to have dependent personality disorder, low production and concentration, anxiety, depression, suicidal ideation and hopelessness, superimposing two or more psychological disorders. These factors should be pondered for a better resolution in the treatment of CDH.

headaches disorders; migraine; psychology

Characteristic	Chronic daily headaches (n=100)	Episodic migraines (n=40)	p-value
Characteristic	N (%) or mean±SD		p-value
Gender
Male	10 (10.0)	9 (22.5)	0.066
Female	90 (90.0)	31 (77.5)	0.066
Age (years)	44±14.1	37±12.7	0.0049
Marital status
Single	21 (21.0)	10 (25.0)	0.600
Married	67 (67.0)	24 (60.0)	0.439
Separated/divorced	5 (5.0)	4 (10.0)	0.307
Widowed	7 (7.0)	2 (5.0)	0.712
Employment status
Unemployed	62 (62.0)	15 (37.5)	0.011
Employed	38 (38.0)	25 (62.5)	0.011
Schooling
Less than 1 year	6 (6.0)	1 (2.5)	0.444
2-7 years	48 (48.0)	9 (22.5)	0.005
8-10 years	14 (14.0)	5 (12.5)	0.842
11 or more years	32 (32.0)	25 (62.5)	0.001

Subtypes of Neuroticism	CDH		EM		p-value
	n	%	n	%
Dependent personality disorder*	60	60	8	20	<0.0001
Avoidant personality disorder*	9	9	14	35	0.0005
Antisocial or Borderline personality disorder	12	12	2	5	0.2268
Low capacity of concentration and production*	3	3	12	30	<0.0001
Anxiety disorder*	59	59	11	27.5	0.0008
Depressive disorder*	45	45	4	10	<0.0001
Difficulties to perceive their problems*	10	10	16	40	0.0001
Suicidal ideation*	25	25	1	2.5	0.0008
Despair*	72	72	0	0	<0.0001
Evidence of at least 1 disorder *	90	90	27	67.5	0.0060
Evidence of 3 or more disorders*	34	34	2	5	0.0002
Depression and suicidal ideation	24	24	1	2.37	0.3391
Depression and despair	24	24	0	0	0.0597
Suicidal ideation without depression	1	1	0	0	0.7252
Despair without depression*	47	47	0	0	<0.0001

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[1] Correspondence:
Maria Aparecida Junqueira Zampieri; Rua Dr. Presciliano Pinto, 2350; 15020-000 São Paulo SP, Brasil; E-mail: zampierimaj@ciclomuta.com.br