Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
Department of Biomedical and NeuroMotor Sciences - DiBiNeM, University of Bologna, Bologna, Italy; IRCCS Institute of Neurological Sciences of Bologna - AUSL Bologna, Bologna, Italy.
J Psychosom Res. 2018 Aug;111:52-57. doi: 10.1016/j.jpsychores.2018.05.011. Epub 2018 May 21.
Illness perception is significantly related to several outcome measures in different medical conditions. However, little is known about headache-related causal attributions and cognitive and emotional representations in patients with migraine.
To examine perceived causes of headache and demographic, clinical, and psychological correlates and predictors of illness perception in patients with migraine attending a tertiary care headache centre.
A sample of 143 patients with migraine (85.3% women, mean age 44.0 ± 12.1 years) completed the Brief Illness Perception Questionnaire (Brief IPQ), the Symptom Questionnaire (SQ), and the Migraine Disability Assessment (MIDAS) Questionnaire. A set of demographic and clinical characteristics was also collected.
Stress, heredity, and nervousness were the most frequent perceived causes of headache. Female gender was significantly related to higher Brief IPQ "consequences" and "emotional response" scores. Increased psychological distress and a poorer clinical course were significantly associated with more negative illness representations. In multiple regression analysis, a longer illness duration, increased depressive symptoms, and higher levels of headache-related disability and painfulness of headache attacks independently predicted a worse illness perception.
In patients with migraine, depressive symptoms and a worse disease status, characterized by a longer history of suffering, higher disability and more painful headache attacks, may negatively affect illness perception. It could also be that dysfunctional illness representations lead to depressive symptoms and decrease patients' motivation to adhere to treatments, resulting in a worse outcome. Future studies should examine whether the improvement of illness perception through specific psychological interventions may promote a better adaptation to migraine.
在不同的医学病症中，疾病感知与多种结果测量显著相关。然而，对于偏头痛患者的头痛相关因果归因以及认知和情绪表现，我们知之甚少。
在偏头痛患者中，调查头痛感知原因以及人口统计学、临床和心理相关因素和预测因素，这些患者就诊于三级保健头痛中心。
我们对 143 名偏头痛患者（85.3%为女性，平均年龄 44.0±12.1 岁）进行了样本调查，他们完成了简明疾病感知问卷（Brief IPQ）、症状问卷（SQ）和偏头痛残疾评估（MIDAS）问卷。还收集了一组人口统计学和临床特征。
压力、遗传和紧张被认为是头痛最常见的原因。女性性别与较高的 Brief IPQ“后果”和“情绪反应”评分显著相关。较高的心理困扰和较差的临床病程与更消极的疾病认知显著相关。在多元回归分析中，较长的疾病持续时间、增加的抑郁症状、以及更高水平的头痛相关残疾和头痛发作的疼痛程度，独立预测了较差的疾病感知。
在偏头痛患者中，抑郁症状和更差的疾病状态，表现为较长的患病历史、更高的残疾和更疼痛的头痛发作，可能会对疾病感知产生负面影响。也可能是功能失调的疾病认知导致抑郁症状，并降低患者对治疗的依从性，导致结果更差。未来的研究应检查通过特定的心理干预改善疾病认知是否可以促进更好地适应偏头痛。
