Gerber Megan R, Fried Lise E, Pineles Suzanne L, Shipherd Jillian C, Bernstein Carolyn A
VA Boston Healthcare System/Women’s Health, Boston University School of Medicine, 150 S. Huntington Ave., Jamaica Plain, MA 02130, USA.
Women Health. 2012;52(5):454-71. doi: 10.1080/03630242.2012.684088.
Posttraumatic stress disorder has been linked to women's ill health, including headaches. Intimate partner violence, which may result in posttraumatic stress disorder, is often reported by women with headaches. Prior studies of intimate partner violence and headache have estimated lifetime but not 12-month prevalence. The researchers in this study examined the relationship between headache and posttraumatic stress disorder in a novel population, and estimated 12-month and lifetime prevalence rates of intimate partner violence.
Patients were recruited from a women's headache center (n = 92) during 2006-07 and completed the Migraine Disability Assessment measure of headache severity. Posttraumatic stress disorder was measured using a modified Breslau scale. Twelve-month and lifetime physical intimate partner violence were measured with the Partner Violence Screen and the STaT ("slapped, threatened and throw") measure. Multivariable regression determined factors independently associated with headache severity.
Among all participants, 28.3% screened positive for posttraumatic stress disorder; 9.8% and 36.9% of women endorsed recent and lifetime intimate partner violence. Posttraumatic stress disorder was strongly associated with headache severity (β = 34.12, p = 0.01). Patients reporting lifetime intimate partner violence exhibited a trend of nine additional days of disability due to headache over 90 days.
Posttraumatic stress disorder and intimate partner violence occur among a sizable proportion of women referred for headache. The authors' findings reaffirm that clinicians treating women with headaches must be aware of the possibility of posttraumatic stress disorder and intimate partner violence in such patients.
创伤后应激障碍与女性的健康问题有关,包括头痛。亲密伴侣暴力可能导致创伤后应激障碍,经常有头痛的女性报告遭受过这种暴力。先前关于亲密伴侣暴力与头痛的研究估计了终生患病率,但未估计12个月患病率。本研究的研究人员在一个新的人群中研究了头痛与创伤后应激障碍之间的关系,并估计了亲密伴侣暴力的12个月和终生患病率。
2006年至2007年期间,从一家女性头痛中心招募了患者(n = 92),并完成了偏头痛残疾评估量表以评估头痛严重程度。使用改良的布雷斯劳量表测量创伤后应激障碍。用伴侣暴力筛查量表和STaT(“被扇耳光、受到威胁和被扔东西”)量表测量12个月和终生身体亲密伴侣暴力情况。多变量回归确定与头痛严重程度独立相关的因素。
在所有参与者中,28.3%的人创伤后应激障碍筛查呈阳性;9.8%和36.9%的女性认可近期和终生亲密伴侣暴力。创伤后应激障碍与头痛严重程度密切相关(β = 34.12,p = 0.01)。报告终生亲密伴侣暴力的患者在90天内因头痛导致的残疾天数有增加九天的趋势。
在因头痛就诊的相当一部分女性中存在创伤后应激障碍和亲密伴侣暴力。作者的研究结果再次证实,治疗头痛女性的临床医生必须意识到此类患者存在创伤后应激障碍和亲密伴侣暴力的可能性。