Kao Chi-Han, Wang Shuu-Jiun, Tsai Chia-Fen, Chen Shih-Pin, Wang Yen-Feng, Fuh Jong-Ling
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
Cephalalgia. 2014 Mar;34(3):211-8. doi: 10.1177/0333102413505238. Epub 2013 Sep 18.
To evaluate the prevalence and the association of psychological disturbance in migraine patients with allodynia.
We recruited 434 migraine patients from an outpatient clinic. The participants completed three self-administered questionnaires, including a headache questionnaire, an allodynia symptoms checklist, and the Hospital Anxiety and Depression Scale (HADS).
Among the migraineurs, 48.4% participants reported allodynia. The HADS total score (15.5 ± 7.8 vs. 13.7 ± 8.5, P = 0.022) and anxiety subscore (9.1 ± 4.5 vs. 7.6 ± 4.7, P = 0.001) were higher in migraineurs with allodynia than in those without allodynia. The anxiety subscore in patients with moderate to severe allodynia, mild allodynia, and no allodynia were 10.0 ± 4.5, 8.4 ± 4.3, and 7.6 ± 4.7 ( P < 0.001, by one-way analysis of variance). Among patients with moderate to severe allodynia, there was a trend of higher depression subscore (7.1 ± 4.0, P = 0.059) than those with no (6.1 ± 4.4) or mild allodynia (5.8 ± 4.0). In a regression model, the presence of allodynia is an independent risk factor for clinically significant anxiety. Moderate to severe allodynia is an independent risk factor for clinically significant depression.
In migraineurs, the severity of cutaneous allodynia was associated with their mood status, especially anxiety.
评估偏头痛合并痛觉过敏患者心理障碍的患病率及其相关性。
我们从一家门诊诊所招募了434名偏头痛患者。参与者完成了三份自我管理问卷,包括头痛问卷、痛觉过敏症状清单和医院焦虑抑郁量表(HADS)。
在偏头痛患者中,48.4%的参与者报告有痛觉过敏。有痛觉过敏的偏头痛患者的HADS总分(15.5±7.8 vs. 13.7±8.5,P = 0.022)和焦虑子得分(9.1±4.5 vs. 7.6±4.7,P = 0.001)高于无痛觉过敏的患者。中度至重度痛觉过敏、轻度痛觉过敏和无痛觉过敏患者的焦虑子得分分别为10.0±4.5、8.4±4.3和7.6±4.7(通过单因素方差分析,P < 0.001)。在中度至重度痛觉过敏患者中,抑郁子得分有高于无痛觉过敏(6.1±4.4)或轻度痛觉过敏(5.8±4.0)患者的趋势(7.1±4.0,P = 0.059)。在回归模型中,痛觉过敏的存在是临床上显著焦虑的独立危险因素。中度至重度痛觉过敏是临床上显著抑郁的独立危险因素。
在偏头痛患者中,皮肤痛觉过敏的严重程度与其情绪状态相关,尤其是焦虑。