Pain interference and depression may be associated with the emotional burden of headache in patients with chronic tension type headache (CTTH), according to a study published in the Journal of Headache and Pain. In addition, pain interference, headache duration, and emotional burden may be associated with the physical burden of headache.
In this study, investigators evaluated the physical and emotional components of headache burden using the Headache Disability Inventory (HDI) at baseline and after one year in 130 patients with CTTH.
Anxiety and depression were also assessed using the Hospital Anxiety and Depression Scale, in addition to sleep quality – evaluated with the Pittsburgh Sleep Quality Index – and quality of life assessed with the Short Form Survey-36 items.
Positive correlations were established between the emotional burden of headache at one year and depression (correlation coefficient, r=.408; P <.001), headache frequency (r =.281; P =.015), and sleep quality (r=.326; P =.004) at baseline. The emotional burden of headache at one year was also negatively correlated with pain interference (r=-0.508; P <.001), vitality (r=-0,374; P =.001), and mental health (r=-0.343; P =.002) at baseline. Positive correlations were established between the physical burden of headache at one year and headache intensity (r=0.228; P =.45), headache frequency (r=0.306; P =.008), headache duration (r=0.376; P =.009), and depression (r=0.330; P =.004) at baseline.
Depression and pain interference at baseline were found in regression analyses to account for 32.2% of the emotional burden of headache (P <.01). The baseline emotional burden of headache, pain interference, and baseline headache duration contributed 46%, 6%, and 3%, respectively, to the physical burden of headache at one year.
Study participants were enrolled from a tertiary headache center, and therefore the findings may not be applicable to the global CTTH patient population. In addition, medication intake was not taken into account in the mediation models.
The investigators suggest that appropriate “management of emotional factors may be relevant for avoiding chronification and an increase of burden perception, since stress and depression are 2 modifiable risk factors that trigger pain in [people with] CTTH.”
Fuensalida-Novo S, Palacios-Ceña M, Fernández-Muñoz JJ, et al. The burden of headache is associated to pain interference, depression and headache duration in chronic tension type headache: a 1-year longitudinal study. J Headache Pain. 2017;18(1):119.