Torelli Paola, Abrignani Giorgia, Castellini Paola, Lambru Giorgio, Manzoni Gian Camillo
Headache Centre Section of Neurology Department of Neuroscience, University of Parma, c/o Ospedale Maggiore Via Gramsci 14, 43100 Parma, Italy.
Neurol Sci. 2008 May;29 Suppl 1:S93-5. doi: 10.1007/s10072-008-0896-3.
The role of psychological factors related to headache, particularly tension-type headache (TTH), has long been a focus of investigation. The subject at issue is a complex one, with some aspects that are still being debated by experts. In episodic TTH, it is possible to hypothesise that headache is not only a "primary" headache that causes gratuitous pain to sufferers. In fact, it might represent an improper mode of communicating the sufferers' intimate discomfort, caused by an inadequate relationship between their personality profiles and events in their lives. As in migraine, in TTH, too, evidence has been found of comorbidity between headache and psychiatric disorders, including depression and anxiety disorder. Such evidence will have to be confirmed by further studies on the general population. As regards behaviour and personality traits, subjects with TTH had significantly higher scores than healthy controls on measures of automatic thoughts and alexithymia, and lower scores on assertiveness. Patients with chronic TTH had higher automatic thoughts scores than patients with episodic TTH. These findings suggest that people with TTH may have difficulty in expressing their emotions. Finally, psychological factors and emotional disturbances have been indicated as risk factors for TTH. Indeed, stress and mental tension are the most common factors that cause TTH.
与头痛尤其是紧张型头痛（TTH）相关的心理因素的作用长期以来一直是研究的焦点。这个问题很复杂，有些方面仍在专家之间存在争议。在发作性TTH中，可以推测头痛不仅是一种给患者带来无端疼痛的“原发性”头痛。事实上，它可能代表了患者因个性特征与生活中的事件之间关系不恰当而产生的内心不适的一种不当表达方式。与偏头痛一样，在TTH中也发现了头痛与精神障碍（包括抑郁症和焦虑症）共病的证据。这些证据必须通过对普通人群的进一步研究来证实。关于行为和个性特征，TTH患者在自动思维和述情障碍量表上的得分显著高于健康对照组，而在自信量表上的得分较低。慢性TTH患者的自动思维得分高于发作性TTH患者。这些发现表明TTH患者可能在表达情绪方面存在困难。最后，心理因素和情绪障碍已被指出是TTH的危险因素。事实上，压力和精神紧张是导致TTH最常见的因素。
