Psychosocial impact of headache and comorbidity with other pains among Swedish school adolescents.

Fichtel A, Larsson B.

Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala Science Park, S-751 83, Sweden.

BACKGROUND: The psychosocial impact of headache combined with other pains has previously been insufficiently investigated. OBJECTIVE: The present study examined the prevalence of headache, its comorbidity with other pains and psychosocial impact among adolescents. METHODS: 793 adolescents in a sample recruited from 8 schools in the middle of Sweden were assessed. RESULTS: Forty-five percent of the adolescents reported ongoing pain during assessment and more than half of the adolescents reported at least one frequent pain during the previous 6 months. The most common pain among girls was headache (42%), but for boys muscle pain (32%) was most prevalent. Number of pains and perceived pain disability were also higher among girls than boys. One-third of the headache sufferers had headache only, while one-third reported one other frequent pain and the others had at least two other frequent pains. Overall, adolescents with frequent headaches had higher levels of anxiety or depressive symptoms, in addition to functional disability and usage of analgesic medication. Frequent headache sufferers reported more problems in everyday life areas than those with infrequent headaches. CONCLUSIONS: It is recommended that adolescents suffering from recurrent headaches routinely should be asked about the presence of other pains, anxiety and depressive symptoms, medication usage, in addition to psychosocial consequences in their everyday life activities. Longitudinal research is also needed to delineate causal relationships between psychosocial factors and recurrent pains, in particular regarding possible sex differences.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12390639&dopt=Abstract headache medicine




A comparison of tension-type headache in migraineurs and in non-migraineurs: a population-based study.

Ulrich V, Russell MB, Jensen R, Olesen J.

Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.

The prevalence, sex-ratio and clinical characteristics of tension-type headache were analyzed in 4000 people from the general population. The one-year-period prevalence of tension-type headache was not significantly different in people with migraine without aura (83%), in people with migraine with aura (75%) and in people who had never had migraine (76%). The male/female ratio varied from 1:1.19 to 1:1.23 and was not significantly different in the three subgroups. Tension-type headache was significantly more frequent within the last year and lasted longer in migraineurs than in people who had never had migraine. The pain characteristics and accompanying symptoms were very similar in the three subgroups. Tension-type headache was often precipitated by stress, mental tension and tiredness. Only migraineurs had episodes of tension-type headache precipitated by alcohol, over-matured cheese, chocolate and physical activity. We conclude that tension-type headache and migraine are separate disorders and not part of a continuum of headache disorders. However, migraine may aggravate and precipitate tension-type headache possibly due to convergence of various noxious peripheral input into the trigeminal nucleus.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8951947&dopt=Abstract headache medicine




An epidemiologic study of headache among children and adolescents of southern Brazil.

Barea LM, Tannhauser M, Rotta NT.

Curso de Pos-Graduacao em Farmacologia da Fundacao Faculdade Federal de Ciencias Medicas de Porto Alegre, RS, Brazil.

To study the epidemiology of pediatric headache, we conducted a cross-sectional study of a randomized and proportional sample of 538 male and female students, 10 to 18 years old. They were in the 5th to 8th grade of the schools of Porto Alegre, RS, Brazil. The headache disorders were classified on the basis of clinical interview as well as a physical and neurological examination using the operational diagnostic criteria of the International Headache Society (IHS). The following headache prevalences were found: lifetime, 93.2%; last year, 82.9%; last week, 31.4%; last 24 h, 8.9%. Last week and last 24 h headache complaints were twice as prevalent in the female group. During the last year the prevalence of headache disorders was 72.8% for tension-type and 9.9% for migraine headache and was not associated with age distribution. Only the last year and last week prevalences of tension-type headache were significantly higher in the female group. The last year prevalence of headache disorders proved to be positively associated with sex and age variables. The prevalence of headache disorders was found to be extremely high in this population group, requiring more attention on the part of investigators as a public health problem.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8980856&dopt=Abstract headache medicine




Acetazolamide testing of cerebral vasodilator capacity provokes "vascular" but not tension headaches.

Shirai T, Meyer JS, Akiyama H, Mortel KF, Wills PM.

Department of Neurology, Baylor College of Medicine, Houston, Tex, USA.

Cerebrovascular capacitance was tested by measuring local cerebral blood flow (LCBF) by xenon-contrasted CT scanning before and after the oral administration of 14.3 mg/kg of acetazolamide among 45 subjects including 15 age-matched controls without history of headache, 20 migraineurs with and without aura, 3 patients with cluster headache, and 7 patients with tension-type headache. Percentage increases of LCBF were measured in 10 regions located throughout both hemispheres. Laterality indices for asymmetric LCBF increases were calculated. Local cerebral blood flow in cortical gray matter increased 5.9% in controls, 9.9% in patients with tension headaches, but 18.6% in both migraine and cluster headache patients; significantly greater LCBF increases than among controls or among patients with tension headaches (P < 0.05). Increases in LCBF were significantly asymmetric among migraine and cluster patients and provoked typical unilateral vascular headaches which responded to sumatriptan. Maximal asymmetric LCBF increases also corresponded to the reported side of the induced headaches confirming their vascular pathogenesis. Patients with tension headaches and controls without history of headache did not develop head pain after acetazolamide.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8990598&dopt=Abstract headache medicine




Relative contributions of life events versus daily hassles to the frequency and intensity of headaches.

Fernandez E, Sheffield J.

Department of Psychology, Southern Methodist University, Dallas, TX 75275-0442, USA.

This study investigated headaches parameters (frequency and intensity) in relation to (the number and severity of) two types of psychosocial stress: major life events (as assessed by a revised Social Readjustment Rating Scale) and minor daily hassles (as assessed by a revised Hassles Scale). Subjects were 261 volunteers reporting headache. Results revealed that both headache frequency and intensity were significantly predicted by daily hassles, in particular, the average severity of these hassles, but there was a negligible relationship between headache parameters and any of the life event measures. Furthermore, a significant relationship emerged between life events and daily hassles themselves. This fits with recent findings that life events (while exerting little direct effect on headache) may trigger a succession of hassles which culminate in headaches. Also, it is not the number of hassles, but the perceived severity of these hassles that best predicts headache frequency and intensity. Finally, though significant as predictors, daily hassles explained a small portion of the variance in headache, thus pointing to the host of other possible biological and psychosocial contributions to headache.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8990599&dopt=Abstract headache medicine




Cluster headache is an inherited disorder in some families.

Russell MB, Andersson PG, Iselius L.

Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.

We investigated the familial occurrence of cluster headache in 370 probands with cluster headache, diagnosed according to the operational diagnostic criteria of the international Headache Society. Seven probands belonged to three families. A positive family history of cluster headache was found in 7% (25 of 366) of the families. Compared with the general population, the first- and second-degree relatives of the 370 probands with cluster headache had a 14- and 2-fold increased risk of having cluster headache, after standardization for sex and age. This increased familial risk strongly suggests that cluster headache has a genetic cause. The patterns of segregation were assessed by complex segregation analysis performed with the computer program, POINTER. The segregation analysis suggests that cluster headache has an autosomal dominant gene with a penetrance of 0.30 to 0.34 in males and 0.17 to 0.21 in females. The gene is present in 3% to 4% of males and 7% to 10% of females with cluster headache.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8990601&dopt=Abstract headache medicine




Effects of headaches during neuropsychological testing of mild head injury patients.

Tsushima WT, Newbill W.

Straub Clinic and Hospital, Honolulu, Hawaii 96813, USA.

The Luria-Nebraska Neuropsychological Battery (LNNB) and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to 37 mild head injury patients, whose headache activity was rated at the time of testing. A one-way analysis of variance (ANOVA) compared each of the 11 LNNB scores of patients with severe headache, mild headache, and no headache. The results revealed no significant differences on varied neuropsychological tests between the three headache groups. Similar analyses of the 13 MMPI scores also indicated no significant differences between the three headache groups across various psychoemotional measures. The results are consistent with previous research and suggest that headaches do not affect the performance of mild head injury patients on varied neuropsychological tests requiring concentration and immediate memory, but because of the small number of patients in this study the findings should be considered tentative.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8990602&dopt=Abstract headache medicine




Sociodemographic factors and primary headache syndromes in a Saudi community.

Abdul Jabbar M, Ogunniyi A.

King Khalid University Hospital, Riyadh, Saudi Arabia.

BACKGROUND AND PURPOSE: There is increasing evidence that the pathophysiologic mechanisms are different between migraine and tension-type headache. The aim of the study was to determine possible sociodemographic differences in Saudi Arabia subjects with headache. METHODOLOGY: A community-based door-to-door survey with identification of headache cases based on IHS criteria. A comparison of sociodemographic variables was made between subjects with migraine and tension-type headache. RESULTS: Headache prevalence was 8% (95% CI = 7.3-8.7%) with a preponderance of tension-type headache (39%). Females were more often affected than males (ratio 2:1). Migraine subjects were more often in the professional occupational group compared with tension-type headache (p < 0.05). CONCLUSION: Headache prevalence in the community was low. Subjects with migraine and tension-type headache were similar with respect to many demographic variables. Occupational association needs verification in further studies.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8994940&dopt=Abstract headache medicine