Gesztelyi Gyöngyi, Bereczki Dániel
Neurology and Headache Outpatient Clinic, City Health Service of Debrecen, and Department of Neurology, University of Debrecen, Hungary.
Psychiatry Clin Neurosci. 2006 Jun;60(3):271-6. doi: 10.1111/j.1440-1819.2006.01501.x.
The aim of this study was to test whether the association between disability and depressive symptoms in patients with cervicogenic headache is similar to that found in primary headaches or to the pattern found in low back pain. During a 2-year period, 716 consecutive patients with the clinical diagnosis of cervicogenic headache (n=182), low back pain (n=116), migraine (n=231), tension-type headache (n=176), and cluster headache (n=11) filled in the Beck Depression Inventory (BDI). Disability was scored by the migraine disability score questionnaire reflecting the number of days with lost or decreased work, household and social activities. Non-parametric tests and multiple general regression were used for statistical analysis. In multivariate testing, significant independent determinants of disability were pain frequency, pain intensity and the severity of depressive symptoms in migraine and tension-type headache; pain frequency and the BDI score in cervicogenic headache, and pain frequency alone in low back pain. Disability is related to pain frequency in all pain syndromes evaluated in the present study. The level of disability is associated with the severity of pain only in primary headaches, but not in pain syndromes of vertebral origin (cervicogenic headache and low back pain). Disability is associated with the severity of depressive symptoms in all headache types but not in low back pain. Both the location and the etiology of pain have importance in determining the interrelationship between pain characteristics, depression and disability.
本研究的目的是检验颈源性头痛患者的残疾与抑郁症状之间的关联是否与原发性头痛患者中发现的关联相似，或者与腰痛患者中发现的模式相似。在两年期间，716名连续的临床诊断为颈源性头痛（n = 182）、腰痛（n = 116）、偏头痛（n = 231）、紧张型头痛（n = 176）和丛集性头痛（n = 11）的患者填写了贝克抑郁量表（BDI）。残疾程度通过偏头痛残疾评分问卷进行评分，该问卷反映了工作、家庭和社交活动丧失或减少的天数。采用非参数检验和多元线性回归进行统计分析。在多变量测试中，残疾的显著独立决定因素在偏头痛和紧张型头痛中是疼痛频率、疼痛强度和抑郁症状的严重程度；在颈源性头痛中是疼痛频率和BDI评分，而在腰痛中仅是疼痛频率。在本研究评估的所有疼痛综合征中，残疾与疼痛频率相关。残疾程度仅在原发性头痛中与疼痛严重程度相关，而在脊椎源性疼痛综合征（颈源性头痛和腰痛）中则不然。在所有头痛类型中，残疾与抑郁症状的严重程度相关，但在腰痛中则不然。疼痛的部位和病因在确定疼痛特征、抑郁和残疾之间的相互关系方面都很重要。
