Guidetti V, Galli F, Fabrizi P, Giannantoni A S, Napoli L, Bruni O, Trillo S
Interuniversity Center for the Study of Headaches and Neurotransmitter Disorders, Section of Rome, Italy.
Cephalalgia. 1998 Sep;18(7):455-62. doi: 10.1046/j.1468-2982.1998.1807455.x.
Migraine with juvenile onset changes over time. The existence of prognostic factors is a point of focus. A strict relationship between migraine or tension-type headache (TTH) and psychiatric factors has been suggested, but the exact role and the influence on evolution of headache is unknown.
To analyze the evolution of migraine and TTH and psychiatric comorbidity (P-Co) from 1988 to 1996.
100 subjects (40M, 60F; mean age 17.9 years; SD 2.7 years; range 12-26 years) were examined at our Center. The International Headache Society (IHS) criteria were employed. Psychometric tests and clinical interviews aided psychiatric diagnosis (DSM-III-R). SCID (Structured Clinical Interview for DSM-III-R) was employed in 1996. Chi square and logistic regression are used for statistical analysis.
Migraine and TTH change their clinical characteristics, with a high tendency to remission (mostly in males). The presence of P-Co in 1988 is related to a worsening or unchanging situation in 1996. Headache-free subjects did not present any psychiatric disorders in 1996. Anxiety disorders in 1988 are related to enduring of headache. Migraine shows comorbidity with anxiety disorders and depression.
P-Co is a notable problem in clinical practice. Diagnostic, prognostic, and treatment implications require a systematic assessment of P-Co.
青少年期起病的偏头痛会随时间变化。预后因素的存在是一个关注焦点。偏头痛或紧张型头痛（TTH）与精神因素之间存在紧密联系，但确切作用以及对头痛演变的影响尚不清楚。
分析1988年至1996年偏头痛和TTH以及精神共病（P-Co）的演变情况。
我们中心对100名受试者（40名男性，60名女性；平均年龄17.9岁；标准差2.7岁；年龄范围12 - 26岁）进行了检查。采用国际头痛协会（IHS）标准。心理测量测试和临床访谈辅助精神疾病诊断（DSM-III-R）。1996年使用了DSM-III-R的结构化临床访谈（SCID）。采用卡方检验和逻辑回归进行统计分析。
偏头痛和TTH会改变其临床特征，缓解倾向较高（主要在男性中）。1988年存在P-Co与1996年病情恶化或无变化相关。无头痛的受试者在1996年未出现任何精神疾病。1988年的焦虑症与头痛持续有关。偏头痛与焦虑症和抑郁症存在共病情况。
P-Co在临床实践中是一个显著问题。诊断、预后和治疗方面的影响需要对P-Co进行系统评估。
