Danish Headache Center, Rigshospitalet‒Glostrup, University of Copenhagen, Glostrup, Denmark.
Center for Clinical Research and Prevention, Bispebjerg og Frederiksberg Hospital, Frederiksberg, Denmark.
Cephalalgia. 2021 Nov;41(13):1318-1331. doi: 10.1177/03331024211020392. Epub 2021 Jun 23.
To explore the prevalence of poor social support and loneliness among people with chronic headache, and how these might be effect modifiers in the relationships between chronic headache and stress, medication overuse, and self-rated health.
Poor social support and loneliness are consistently linked to worse health outcomes. There are few epidemiologic studies on their effect on headache.
The Danish Capital Region Health Survey, a cross-sectional survey, was conducted in 2017. Participants were asked about headache, pain medication use, social support, loneliness, perceived stress, and self-rated health. Data were accessed from sociodemographic registers. Logistic regression analyses were performed to test for effect modification.
The response rate was 52.6% (55,185 respondents) and was representative of the target population. People with chronic headache were more likely to report poor social support and loneliness compared to those without chronic headache ( < 0.0001 for both). Odds ratios for the combination of chronic headache and poor social support were very high for stress (odds ratio 8.1), medication overuse (odds ratio 21.9), and poor self-rated health (odds ratio 10.2) compared to those without chronic headache and with good social support. Those who reported both chronic headache and loneliness had a very high odds ratio for stress (odds ratio 14.4), medication overuse (odds ratio 20.1), and poor self-rated health (odds ratio 15.9) compared to those without chronic headache and low loneliness score. When adjusted for sociodemographic factors, poor social support and loneliness were not significant effect modifiers in almost all these associations. Loneliness was a significant effect modifier in the association between chronic headache and medication overuse, but exerted greater effect among those who did not report they were lonely.
Poor social support and loneliness were prevalent among people with chronic headache. The combination of chronic headache and poor social support or loneliness showed higher odds ratios for stress, medication overuse, and poor self-rated health compared to those with good social support and low loneliness scores. The effect of loneliness in the relationship between chronic headache and medication overuse warrants further study.
探讨慢性头痛患者社会支持不足和孤独感的流行情况，以及这些因素如何影响慢性头痛与压力、药物滥用和自我评估健康之间的关系。
社会支持不足和孤独感与较差的健康结果密切相关。但关于它们对头痛影响的流行病学研究较少。
2017 年进行了丹麦首都地区健康调查，这是一项横断面调查。参与者被问及头痛、止痛药使用、社会支持、孤独感、感知压力和自我评估健康。数据取自社会人口学登记册。采用逻辑回归分析来检验效应修饰作用。
应答率为 52.6%（55185 名应答者），具有代表性。与无慢性头痛者相比，慢性头痛患者更有可能报告社会支持不足和孤独感（均 < 0.0001）。与社会支持良好且无慢性头痛者相比，慢性头痛和社会支持不足患者的压力（比值比 8.1）、药物滥用（比值比 21.9）和自我评估健康状况差（比值比 10.2）的组合发生几率非常高。与无慢性头痛且孤独感得分较低者相比，报告同时患有慢性头痛和孤独感的患者压力（比值比 14.4）、药物滥用（比值比 20.1）和自我评估健康状况差（比值比 15.9）的几率非常高。调整社会人口学因素后，在几乎所有这些关联中，社会支持不足和孤独感都不是显著的效应修饰因素。孤独感是慢性头痛与药物滥用之间关联的一个显著的效应修饰因素，但在不报告孤独感的人群中，其影响更大。
慢性头痛患者社会支持不足和孤独感较为普遍。与社会支持良好且孤独感得分较低者相比，慢性头痛与社会支持不足或孤独感并存者的压力、药物滥用和自我评估健康状况差的几率更高。孤独感在慢性头痛与药物滥用之间关系中的作用值得进一步研究。
