Psychological aspects of migraine

Henryk-Gutt, Rita; Rees, W. Linford

doi:10.1016/0022-3999(73)90015-9

Cited by 171 publications

(75 citation statements)

References 13 publications

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“…Several studies have shown that stress is one of the most common trigger factors for headache, both in migraine and in tension-type headache [1][2][3][4][5]. It is reasonable, therefore, that stress may exert effects on the clinical evolution of these headaches.…”

Section: Introductionmentioning

confidence: 99%

Stress and chronic headache

D’Amico¹,

Libro²,

Prudenzano³

et al. 2000

J Headache Pain

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IntroductionIt is a matter of clinical experience that psychological factors, in particular stress, can exert notable effects on primary headaches. Several studies have shown that stress is one of the most common trigger factors for headache, both in migraine and in tension-type headache [1][2][3][4][5]. It is reasonable, therefore, that stress may exert effects on the clinical evolution of these headaches. For example, stressful events may increase headache frequency or promote transformation of an episodic headache into a chronic form. A chronic headache is one present on average more than 15 days per month [6]. A transformed headache is an originally episodic headache that developed into a chronic one.A stressful event is an environmental situation or psychological trauma that compromises or threatens wellbeing. Several models have been proposed to explain how stress can influence headache. More recent theories do not consider stress as a purely exogenous factor but recognise that stressful events can induce objective biological and psychological changes.Stress acts on the body via the endocrine system, autonomic nervous system and immune system [7][8][9]. These systems act as biological integrators in the body, functioning to maintain homeostasis. In turn they are influenced by such factors as genetic makeup or constitution, psychobiological imprinting and the external environment (the sum of physical, emotional and social stimuli). Stressful events affect the brain through inputs from the cortex, subcortical regions, and sensory organs, and from the endocrine system, provoking reactions mediated, principally, by the hypothalamo-hypophyseal-adrenal axis (CRH) and by the locus coeruleus (norepinephrine). The effects of these multifarious hormonal and neurotransmitter changes vary with the duration of the stressful stimulus. Prolonged and repeated exposure to stressful stimuli may lead to permanent functional changes and even to anatomical damage, and can thus assume the role of a pathogenetic agent or illness precursor. Abstract The aims of this study were to assess how stress affects chronic headaches, and in particular to determine whether events play a role in the transformation of an episodic headache into a chronic form. A population of 267 Italian patients with chronic headache (headache present on average more than 15 days per month) was studied. Our results confirm a triggering role of stress on headache. We also found that episodic headache (migraine in most patients, 74.1%) preceded the development of a chronic form in about 90% cases. Among these patients, in 44.8% a stressful event correlated with the transformation. Analysis of these events revealed that minor events played a greater role than major life events, suggesting that patients with transformed headache are characterised by a different way of reacting to stress.

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Section: Introductionmentioning

confidence: 99%

Stress and chronic headache

D’Amico¹,

Libro²,

Prudenzano³

et al. 2000

J Headache Pain

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show abstract

“…Migraine, episodic tensiontype, and chronic tension-type headache cases selected from a community sample were stud ied by Phillips [37], These groups were indis tinguishable from each other on any of the four personality dimensions measured by the personality questionnaire, but differences were found in those taking certain treatments. Using a random sample of civil servants with migraine, nonmigrainous headaches, and no headache, Henryk-Gutt and Rees [38] ob tained details of personal, medical, and family histories by interview. This study pro vided evidence that migraine was associated with increased N scores of the Eysenck Per sonality Inventory, increased anxiety and somatization scores on the Minnesota Multiphasic Personality Inventory (MMPI) (women only), and increased hostility scores on the Buss Scale.…”

Section: Characteristics Of Migraineursmentioning

confidence: 99%

Epidemiology of Migraine

Silberstein

Lipton²

1993

Neuroepidemiology

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Migraine epidemiology presents methodological challenges, partially simplified by the use of the new International Headache Society (IHS) Classification. Most previously published migraine studies were clinic-based, which introduces bias since less than 5% of migraineurs consult specialists. A series of population-based studies of migraine prevalence and incidence, based on the new operational IHS criteria, are now available and are reviewed, along with the migraine personality, comorbid psychiatric conditions and neuropsychological impairment. Migraine headaches are now divided into those with aura (classic migraine) and those without aura (common migraine). Headache occurs in about 91% of men and 96% of women, migraine occurs in about 6% of men and 18% of women (one-year prevalence). Migraine is most common in the third decade of life and in lower socioeconomic groups. It is associated with an increased prevalence of depression and panic attacks.

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“…[16][17][18][19] The five controlled studies of the Eysenck Personality Questionnaire revealed that migraineurs had greater levels of neuroticism than those without migraine, but no differences in extroversion or psychoticism. 15,[20][21][22] Therefore, the research findings regarding personality features of migraine are somewhat contradictory and do not consistently demonstrate abnormalities in specific traits, aside from neuroticism. However, few of these studies truly assessed the constructs of personality first described by Wolff, 13 which may indeed be variants of normal personality rather than personality aberrations.…”

mentioning

confidence: 99%

Psychopathology and Headache Syndromes in the Community

Merikangas

1994

Headache

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The present study investigated the association between psychopathology and headache in a prospective longitudinal epidemiologic study of a cohort of 19-and 20-year-olds in Zurich, Switzerland. Prevalence rates of psychopathology by headache subtype were examined both cross-sectionally and longitudinally. Psychiatric disorders were evaluated using a direct interview administered by experienced clinicians. Personality was assessed using the Freiburg Personality Inventory and the Symptom Checklist 90. In general, subjects with migraine had more affective and anxiety disorders and exhibited elevated rates of neuroticism and somatization compared to nonmigraine subjects. When examined by headache subtype, migraineurs with aura exhibited greater rates of psychopathology and more personality abnormalities than any of the other headache subtypes or controls. In contrast to clinical wisdom, subjects with tension-type headache did not differ from controls in rates of psychopathology or on any of the personality or symptom factors.

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Psychological aspects of migraine

Cited by 171 publications

References 13 publications

Stress and chronic headache

Stress and chronic headache

Epidemiology of Migraine

Psychopathology and Headache Syndromes in the Community

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