Poor social support and loneliness in chronic headache: Prevalence and effect modifiers

Abstract

Objective To explore the prevalence of poor social support and loneliness among people with chronic headache, and how these might be effect modifiers in the relationships between chronic headache and stress, medication overuse, and self-rated health. Background Poor social support and loneliness are consistently linked to worse health outcomes. There are few epidemiologic studies on their effect on headache. Methods The Danish Capital Region Health Survey, a cross-sectional survey, was conducted in 2017. Participants were asked about headache, pain medication use, social support, loneliness, perceived stress, and self-rated health. Data were accessed from sociodemographic registers. Logistic regression analyses were performed to test for effect modification. Results The response rate was 52.6% (55,185 respondents) and was representative of the target population. People with chronic headache were more likely to report poor social support and loneliness compared to those without chronic headache ( p < 0.0001 for both). Odds ratios for the combination of chronic headache and poor social support were very high for stress (odds ratio 8.1), medication overuse (odds ratio 21.9), and poor self-rated health (odds ratio 10.2) compared to those without chronic headache and with good social support. Those who reported both chronic headache and loneliness had a very high odds ratio for stress (odds ratio 14.4), medication overuse (odds ratio 20.1), and poor self-rated health (odds ratio 15.9) compared to those without chronic headache and low loneliness score. When adjusted for sociodemographic factors, poor social support and loneliness were not significant effect modifiers in almost all these associations. Loneliness was a significant effect modifier in the association between chronic headache and medication overuse, but exerted greater effect among those who did not report they were lonely. Conclusion Poor social support and loneliness were prevalent among people with chronic headache. The combination of chronic headache and poor social support or loneliness showed higher odds ratios for stress, medication overuse, and poor self-rated health compared to those with good social support and low loneliness scores. The effect of loneliness in the relationship between chronic headache and medication overuse warrants further study.

Social cognition in Chronic Migraine with Medication Overuse: Do you mind what I think?

“…By contrast, it has been shown that headache sufferers had slightly more social support from their families than non-headaches sufferers [75]. Hence, it is di cult to draw de nitive conclusions given the heterogeneity of the clinic populations [70][71][72][73]75]. However, our results suggest that CM + MO patients place importance on tangible support from their family members, although they do not feel much satis ed with the support received from social networks [70,76,77].…”

“…Belot [72] found that patients with severe migraine judged the social support they received worse than the general population did. Others [73] reported that poor social support and loneliness in CM were associated with a tendency to MO. Our research group [74] has also shown that both CM and EM patients felt emotionally lonely and less supported than HC after the COVID-19 outbreak.…”

The Headache Psychologists’ Role in Pediatric and Adult Headache Care: A Qualitative Study of Expert Practitioners

“…When considering differences between pediatric and adult practices, we found that psychologists who work with pediatric populations often find it helpful to incorporate family members within the treatment process. In addition, understanding family members’ role in supporting adult patients undergoing behavioral headache treatment may be helpful, given that lack of social support can result in increased stress and poorer self-rated health for people with headache (Westergaard, Lau, Allesøe, Andreasen, & Jensen, 2021 ).…”

Headache in Workers: A Matched Case–Control Study

“…Headache is one of the commonest symptoms in workers with burnout (a consequence of chronic stress not effectively managed) [ 27 ]. Loneliness and poor social support, factors that in workers exposed to occupational stress determine a high-risk condition known as “isostrain” [ 86 ], are associated with headache [ 87 ]. Studies conducted on patients with chronic migraine have demonstrated that the latter is a vital factor in perceived stress, which affects the quality of life [ 88 ].…”