Quality of life differs among headache diagnoses: analysis of SF-36 survey in 901 headache patients

Abstract

This paper presents the results of health-related quality of life (HRQoL) in 901 patients consecutively visiting a headache clinic of a national medical center in Taipei, Taiwan. HRQoL was evaluated with the Medical Outcome Study-Short Form (SF-36) and the Hospital Anxiety and Depression Scale (HADS). According to the classification criteria for chronic daily headache (CDH) proposed by Silberstein et al. (Neurology 47 (1996) 871) five hundred and ninety-three (66%) patients had CDH, of whom transformed migraine (TM) was diagnosed in 310, and chronic tension-type headache (CTTH) in 231. One hundred and ninety-three patients had episodic migraine. All SF-36 scale scores significantly correlated with the HADS scores and the intensity and frequency of pain. Compared with the normative data, a pervasive multi-dimensional decline of the SF-36 scores was noted among the headache patients except for the physical functioning scale. The decline was most remarkable in the role limitations of physical and emotional dimensions and in the bodily pain. An increasing impairment of the SF-36 scores was noted from migraine to CTTH to TM. After controlling for the HADS, age, gender, education, and chronic illness by multiple linear regression analyses, the patients with TM had the worst SF-36 profile; whereas, the patients with CTTH and migraine had compatible results. This study is the first to demonstrate that the SF-36 scores differ among headache diagnoses. Psychological distress, as well as the percentages of the types of patients, greatly influenced the SF-36 scores in hospital-based headache samples. Our findings also suggest that improvement in the pain profile as well as psychological well-being can predict a generalized improvement in the SF-36 scales in headache patients.

The impact of headache on quality of life

“…Wang et al [21] evaluated HRQoL in 901 patients who visited a headache clinic by using the Medical Outcomes Study short form health survey (SF-36) and the hospital anxiety and depression scale (HADS). They compared HRQoL in 193 patients with episodic migraine and in 541 patients with chronic daily headache (CDH).…”

“…Compared with CTTH patients, TM patients scored significantly lower on all SF-36 scales except for PF and RE. Wang et al [21] concluded that the SF-36 scores in patients with CDH depended on the percentage of the type of patients in the sample: the greater the proportion of TM patients, the more impaired the SF-36 scores were.…”

Health-related quality of life among Canadians with migraine

“…HRQOL measurement tools communicate the impact of illness on the patient's well-being, providing unique insight into the evaluation and management of migraine. Previous studies have indicated significant reductions in HRQOL among subjects with migraine [5][6][7][8][9][10]. Despite the episodic nature of migraine, HRQOL has been shown to be comparable to living with chronic diseases such as diabetes and arthritis [5].…”

Comparison of 3 Needle Sizes for Trigger Point Injection in Myofascial Pain Syndrome of Upper- and Middle-Trapezius Muscle: A Randomized Controlled Trial

“…The administered questionnaire evaluated effect of the disease on well-being and functional status by asking patients to selfrate 36 items that measured 8 health domains, and a single item that measured changes in self-perceived health. 16 The SF-36 is one of the most widely used physical and mental health status instruments and is increasingly being used for measuring outcomes in patients with pain. 17,18 It has established reliability and validity in chronic pain disorders, [19][20][21] and it includes 8 health concepts: (1) limitations on physical activities because of health problems, (2) limitations on social activities because of physical or emotional problems, (3) limitations on usual role activities because of physical health problems, (4) bodily pain, (5) general mental health (psychologic distress and well-being), (6) limitations on usual role activities because of emotional problems, (7) vitality (energy and fatigue), and (8) general health perceptions.…”