Department of Neurology, Universite Francois Rabelais de Tours, CHRU de Tours, 37000 Tours, France.
J Headache Pain. 2010 Jun;11(3):247-53. doi: 10.1007/s10194-010-0208-1. Epub 2010 Apr 11.
The aim of this study is to compare the psychopathology and the quality of life of chronic daily headache patients between those with migraine headache and those with tension-type headache. We enrolled 106 adults with chronic daily headache (CDH) who consulted for the first time in specialised centres. The patients were classified according to the IHS 2004 criteria and the propositions of the Headache Classification Committee (2006) with a computed algorithm: 8 had chronic migraine (without medication overuse), 18 had chronic tension-type headache (without medication overuse), 80 had medication overuse headache and among them, 43 fulfilled the criteria for the sub-group of migraine (m) MOH, and 37 the subgroup for tension-type (tt) MOH. We tested five variables: MADRS global score, HAMA psychic and somatic sub-scales, SF-36 psychic, and somatic summary components. We compared patients with migraine symptoms (CM and mMOH) to those with tension-type symptoms (CTTH and ttMOH) and neutralised pain intensity with an ANCOVA which is a priori higher in the migraine group. We failed to find any difference between migraine and tension-type groups in the MADRS global score, the HAMA psychological sub-score and the SF36 physical component summary. The HAMA somatic anxiety subscale was higher in the migraine group than in the tension-type group (F(1,103) = 10.10, p = 0.001). The SF36 mental component summary was significantly worse in the migraine as compared with the tension-type subgroup (F(1,103) = 5.758, p = 0.018). In the four CDH subgroups, all the SF36 dimension scores except one (Physical Functioning) showed a more than 20 point difference from those seen in the adjusted historical controls. Furthermore, two sub-scores were significantly more affected in the migraine group as compared to the tension-type group, the physical health bodily pain (F(1,103) = 4.51, p = 0.036) and the mental health (F(1,103) = 8.17, p = 0.005). Considering that the statistic procedure neutralises the pain intensity factor, our data suggest a particular vulnerability to somatic symptoms and a special predisposition to develop negative pain affect in migraine patients in comparison to tension-type patients.
本研究旨在比较慢性每日头痛患者中偏头痛和紧张型头痛患者的精神病理学和生活质量。我们招募了 106 名首次在专门中心就诊的慢性每日头痛（CDH）成人患者。根据 IHS 2004 标准和头痛分类委员会的建议（2006 年），使用计算算法对患者进行分类：8 例为慢性偏头痛（无药物过度使用），18 例为慢性紧张型头痛（无药物过度使用），80 例为药物过度使用性头痛，其中 43 例符合偏头痛亚组（m）MOH 标准，37 例符合紧张型头痛亚组（tt）MOH 标准。我们测试了五个变量：MADRS 总分、HAMA 心理和躯体子量表、SF-36 心理和躯体综合成分。我们将有偏头痛症状的患者（CM 和 mMOH）与有紧张型症状的患者（CTTH 和 ttMOH）进行比较，并使用预先设定的偏头痛组疼痛强度更高的 ANCOVA 进行比较。我们未能发现偏头痛组和紧张型组在 MADRS 总分、HAMA 心理子量表和 SF36 身体成分综合评分上有任何差异。偏头痛组的 HAMA 躯体焦虑子量表高于紧张型组（F(1,103)=10.10，p=0.001）。与紧张型亚组相比，偏头痛亚组的 SF36 心理成分综合评分明显更差（F(1,103)=5.758，p=0.018）。在四个 CDH 亚组中，除了一个（身体功能）之外，所有 SF36 维度评分均与调整后的历史对照组相差 20 分以上。此外，与紧张型组相比，偏头痛组有两个子评分显著更受影响，即身体状况躯体疼痛（F(1,103)=4.51，p=0.036）和心理健康（F(1,103)=8.17，p=0.005）。考虑到统计程序中和了疼痛强度因素，我们的数据表明偏头痛患者比紧张型患者更容易出现躯体症状，并且更容易产生负面疼痛影响。
