Westergaard Maria Lurenda, Glümer Charlotte, Hansen Ebba Holme, Jensen Rigmor Højland
Danish Headache Center, Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
Research Center for Prevention and Health, Capital Region of Denmark, Denmark Department of Health Science and Technology, University of Aalborg, Denmark.
Cephalalgia. 2016 Jan;36(1):15-28. doi: 10.1177/0333102415578430. Epub 2015 Mar 24.
This cross-sectional study investigated associations between chronic headache (CH) with and without medication overuse, healthy lifestyle behaviour, and stress.
Questionnaires were sent to 129,150 adults. Those with headache ≥15 days per month for three months were classified as having CH then further described as having medication-overuse headache (MOH) or CH without medication overuse. Associations between headache and daily smoking, physical inactivity, obesity, excessive drinking, illicit drug use, and high stress were analysed by logistic regression.
CH with and without medication overuse (prevalence 1.8% and 1.6%, respectively) had strong, graded associations with stress. Associations with daily smoking, physical inactivity, and obesity were significant only for MOH. Odds for MOH were highest among people who had all three factors compared to those who had none (OR 2.8 in women and 5.1 in men). High stress plus any of these three factors had synergistic effects in MOH but not clearly in those who had CH without overuse. Associations between CH subtypes and excessive drinking or illicit drug use were not statistically significant.
Results suggest strong links between healthy lifestyle behaviour and stress in MOH. Stress reduction and promoting healthy behaviour are highly relevant in MOH management.
本横断面研究调查了伴有和不伴有药物滥用的慢性头痛（CH）、健康生活方式行为与压力之间的关联。
向129,150名成年人发放问卷。那些每月头痛≥15天且持续三个月的人被归类为患有CH，然后进一步描述为患有药物滥用性头痛（MOH）或无药物滥用的CH。通过逻辑回归分析头痛与每日吸烟、缺乏身体活动、肥胖、过度饮酒、非法药物使用和高压力之间的关联。
伴有和不伴有药物滥用的CH（患病率分别为1.8%和1.6%）与压力存在强烈的分级关联。仅MOH与每日吸烟、缺乏身体活动和肥胖之间的关联具有统计学意义。与没有这三个因素的人相比，同时具有这三个因素的人患MOH的几率最高（女性为2.8，男性为5.1）。高压力加上这三个因素中的任何一个在MOH中具有协同作用，但在无药物滥用的CH患者中则不明显。CH亚型与过度饮酒或非法药物使用之间的关联无统计学意义。
结果表明健康生活方式行为与MOH中的压力之间存在紧密联系。减轻压力和促进健康行为在MOH管理中高度相关。
