Scharff L, Turk D C, Marcus D A
Pain Evaluation and Treatment Institute, University of Pittsburgh, School of Medicine 15213, PA, USA.
Headache. 1995 Jul-Aug;35(7):397-403. doi: 10.1111/j.1526-4610.1995.hed3507397.x.
The frequency of common headache instigators or "triggers" and the use of specific behavioral responses to headache episodes were determined using the self-reports of patients with migraine, tension-type, and combined migraine and tension-type headache. Headache diagnostic groups were compared on the nature of headache triggers identified. The diagnostic groups were also compared on the frequency with which they engaged in a set of behavioral responses during headache episodes. No diagnostic group differences were found in triggering stimuli. Emotional, dietary, physical, environmental, and hormonal factors were all reported to be equally likely to precipitate a headache episode regardless of headache diagnosis. There were, however, differences in specific behavioral responses to headache episodes depending upon headache diagnosis. Discriminant analyses were performed to determine the best predictors of headache diagnoses. Migraine patients were significantly more likely to avoid noise, light, social activity, and physical activity compared with tension-type and combined headache patients. When average headache severity was taken into account, the diagnostic group differences in coping responses disappeared. It is concluded from the results of this study that headache severity has a greater impact on coping response than does specific headache diagnosis.
通过偏头痛、紧张型头痛以及偏头痛合并紧张型头痛患者的自我报告,确定了常见头痛诱发因素或“触发因素”的频率,以及对头痛发作采取的特定行为反应。比较了头痛诊断组所确定的头痛触发因素的性质。还比较了诊断组在头痛发作期间采取一系列行为反应的频率。在触发刺激方面未发现诊断组之间存在差异。无论头痛诊断如何,情绪、饮食、身体、环境和激素因素都同样有可能引发头痛发作。然而,根据头痛诊断的不同,对头痛发作的特定行为反应存在差异。进行了判别分析以确定头痛诊断的最佳预测因素。与紧张型头痛和合并性头痛患者相比,偏头痛患者更有可能避免噪音、光线、社交活动和体育活动。当考虑平均头痛严重程度时,应对反应的诊断组差异消失。从这项研究的结果得出结论,头痛严重程度对应对反应的影响比特定的头痛诊断更大。