Choi Y C, Kim W J, Kim C H, Lee M S
Department of Neurology and Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1995 Dec;36(6):508-14. doi: 10.3349/ymj.1995.36.6.508.
BACKGROUND & OBJECTIVES: Chronic headache is commonly encountered in the neurology outpatient clinic and it is often associated with depression. In Korea, however, chronic headache has not yet been systematically investigated. We conducted this study to investigate this clinical characteristics and level of depression in patients who presented migraine, tension-type headache, or transformed migraine.
Among those with chronic headache during the period from January 1, 1994 through December 31, 1994, 131 patients were diagnosed to have either migraine, tension-type headache (by IHS classification), or transformed migraine: migraine in 60 patients, tension-type headache in 49 patients, and transformed migraine in 22 patients. Beck Depression Inventory (BDI) was performed in 116 of the 131 patients.
RESULTS & CONCLUSION: There was no significant difference in the age of onset, duration of headache, and family history among the three groups. However, patients with migraine had a more severe, unilateral, and throbbing characteristic pain than those with a tension-type headache. The mean BDI scores in the transformed migraine and the tension-type headache patients were significantly higher than those of migraine, but the level of depression did not correlate with the patient's age, duration, character, severity, and frequency of headache. These findings suggest that migraine, tension-type headache and transformed migraine may be considered clinically distinct entities in viewing their different clinical characteristics and level of depression.
慢性头痛在神经内科门诊较为常见，且常与抑郁症相关。然而，在韩国，慢性头痛尚未得到系统研究。我们开展本研究以调查偏头痛、紧张型头痛或转化型偏头痛患者的临床特征及抑郁程度。
在1994年1月1日至1994年12月31日期间患有慢性头痛的患者中，131例被诊断为偏头痛、紧张型头痛（按照国际头痛协会分类）或转化型偏头痛：偏头痛60例，紧张型头痛49例，转化型偏头痛22例。131例患者中的116例进行了贝克抑郁量表（BDI）测试。
三组患者在发病年龄、头痛持续时间及家族史方面无显著差异。然而，偏头痛患者的疼痛比紧张型头痛患者更严重、呈单侧且搏动性。转化型偏头痛和紧张型头痛患者的BDI平均得分显著高于偏头痛患者，但抑郁程度与患者的年龄、病程、疼痛性质、严重程度及头痛频率无关。这些发现表明，从不同的临床特征及抑郁程度来看，偏头痛、紧张型头痛和转化型偏头痛在临床上可能是不同的疾病实体。
