Altintaş Ebru, Karakurum Göksel Başak, Saritürk Çağla, Taşkintuna Nilgün
Department of Psychiatry, Başkent University Faculty of Medicine, Adana, Turkey.
Department of Biostatistics, Başkent University Faculty of Medicine, Adana, Turkey.
Noro Psikiyatr Ars. 2015 Sep;52(3):267-271. doi: 10.5152/npa.2015.8833. Epub 2015 Jul 7.
We aimed to evaluate the prevalence and relationship between childhood maltreatment (CMT) among patients with medication overuse headache (MOH) and to investigate whether CMT is associated with medication overuse in patients having headaches or with headaches that become chronic. Epidemiological studies report a relationship between childhood abuse and headache. There is growing knowledge about the evidence that childhood maltreatment leads to neurobiological sequel. Medication overuse is the most important problem for migraine to become chronic. But in the literature, there was no information about the role of childhood abuse in MOH and for migraine to become chronic.
A total of 116 patients with headache, aged from 15 to 65 years, were included in the study. Patients having chronic migraine (CM), MOH and episodic migraine (EM) were selected out of patients presented to the headache outpatient clinic. Types of headache were determined according to the revised International Headache Society (IHS) criteria published in 2004. The Childhood Trauma Questionnaire, Beck Depression Inventory and Beck Anxiety Inventory were performed. Presence of psychiatric co-morbidities was evaluated by a clinician using Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, the Fourth Edition.
A total of 116 patients with headache were included in the study. Of patients, 64 had MOH, 25 had CM and 27 had EM. The prevalence of CMT, particularly emotional neglect (62%), physical neglect (44%) and emotional abuse (36.2%), was determined higher in all headache groups. There was no statistically significant difference in prevalence of childhood maltreatment between MOH, CM and EM groups. No statistically significant difference was detected between educational status, psychiatric co-morbidities and childhood trauma, except for physical neglect.
Childhood maltreatment was observed in MOH as in other forms of migraine and headache. However, no significant difference was observed between the three groups of patients with headache.
我们旨在评估药物过量使用性头痛（MOH）患者中儿童期虐待（CMT）的患病率及其关系，并调查CMT是否与头痛患者的药物过量使用或慢性头痛有关。流行病学研究报告了儿童期虐待与头痛之间的关系。关于儿童期虐待导致神经生物学后遗症的证据的认识正在不断增加。药物过量使用是偏头痛转为慢性的最重要问题。但在文献中，没有关于儿童期虐待在MOH以及偏头痛转为慢性中所起作用的信息。
本研究共纳入116例年龄在15至65岁之间的头痛患者。从头痛门诊就诊的患者中选出患有慢性偏头痛（CM）、MOH和发作性偏头痛（EM）的患者。根据2004年发布的修订版国际头痛协会（IHS）标准确定头痛类型。进行儿童创伤问卷、贝克抑郁量表和贝克焦虑量表评估。由临床医生使用《精神障碍诊断与统计手册》第四版的结构化临床访谈来评估精神共病的存在情况。
本研究共纳入116例头痛患者。其中，64例患有MOH，25例患有CM，27例患有EM。在所有头痛组中，CMT的患病率，尤其是情感忽视（62%）、身体忽视（44%）和情感虐待（36.2%），被确定为更高。MOH、CM和EM组之间儿童期虐待的患病率无统计学显著差异。除身体忽视外，在教育程度、精神共病和儿童期创伤之间未检测到统计学显著差异。
在MOH中观察到儿童期虐待与其他形式的偏头痛和头痛一样。然而，三组头痛患者之间未观察到显著差异。
