Chronic daily headache: classification, stress and impact on the quality of life

THESES

Chronic daily headache: classification, stress and impact on the quality of life (abstract)^*. Thesis. São José do Rio Preto, 2006.

José Carlos Busto Galego^**

Chronic daily headache (CDH) is a heterogeneous group of headaches that occurs 15 or more days per month, lasting more than four hours, including those associated with medication overuse. The objectives of this study were: to classify CDH; to assess the quality of life and level of stress of the patients with this type of headache.

A hundred patients, from both sexes, with minimum age of 18 years old were prospectively studied. The inclusion criterion was the presence of primary headache with more than 4-hour duration, a frequency of 15 days or more monthly, in the last three months. The diagnosis was according to the second edition of the International Classification of Headache Disorders (ICHD-II) criteria. The SF-36 questionnaire to observe quality of life and Lipp´s Inventory of Stress Symptoms to diagnose stress were used. Patients with chronic organic disease were not included.

The patients´ mean age was 38.8 years. The majority (87%) was women. CDH mean duration was 4.0 years. Applying the ICHD-II criteria, 17 different types of diagnosis were necessary to classify CDH of these patients. Among these types of diagnosis, 11 presented migraine (80% of the patients). The types with migraine had lower scores according to SF-36 either in physical function (p=0.0015) and social function (p=0.033). A total of 46% of the patients overused medication. Their scores were lower in physical function (p=0.008), bodily pain (p=0.037) and role emotional (p=0.046). Ninety patients presented stress, prevailing the psychological symptoms in 94.5%. Among the patients who presented stress, 2 were at the alert phase, 33 at resistance phase, 46 at almost exhaustion and 9 at exhaustion phase. Stress diminished significantly the scores at the SF-36, except on physical function. There was no association between stress and medication overuse. Comparing the stress phases with SF-36 scores, except on bodily pain scale, the resistance phase showed scores significantly higher than the almost exhaustion phase.

CDH is the result of a convergence of several types of headaches that integrates the ICHD-II. Most patients presented stress and half of them were at the almost exhaustion phase. Stress produced significant reduction in all scales from SF-36 questionnaire, except on physical function. The patients with stress at the almost exhaustion phase showed scores significantly lower than resistance phase in all scales of SF-36 questionnaire, except on bodily pain.

Key words: chronic daily headache, classification, quality of life, stress.

*

Cefaléia crônica diária: classificação, estresse e impacto sobre a qualidade de vida (Resumo). Tese de Doutorado, Faculdade de Medicina de São José do Rio Preto (Área: Ciências da Saúde, Medicina Interna). Orientador: Waldir Antonio Tognola.

Publication Dates

• Publication in this collection
  11 Oct 2006
• Date of issue
  Sept 2006