(922): Differences in patterns of impairment, psychiatric comorbidity and headache beliefs in migraine and chronic tension-type headache

Abstract

The purpose of this study is to examine the differences in headache impact, psychiatric comorbidity and beliefs about headaches in migraine (MI), chronic tension-type headache (CTTH), and healthy controls (HC). Two-hundred and forty CTTH (78.0% female; 94.6% Caucasian; mean age= 37.04), 209 migraine (80.9% female; 91.4% Caucasian; mean age= 38.33), and 89 healthy controls (77.5% female; 89.7% Caucasian; mean age= 38.02) were administered self-report and interview measures assessing headache impact (Medical Outcomes Study, Short Form; MOS-SF; Headache Disability Inventory; HDI), psychiatric diagnosis (Prime-MD diagnostic interview), and two types of headache beliefs: (a) beliefs about factors that influence headaches and headache relief (Headache Locus of Control; HLOC), and (b) the belief that they could take actions to influence their headaches (Headache Self-efficacy; HSE). Consistent with previous research examining psychological characteristics of headache sufferers, higher levels of impairment and psychiatric comorbidity were observed in both MI and CTTH than in HC. However, the pattern of psychiatric comorbidity and impairment differed in MI and CTTH. CTTH sufferers were more likely to have either an anxiety or mood disorder diagnosis than MI sufferers. Furthermore, CTTH patients were also more likely to report mental health disability, pain-related disability, and perceptions of poorer health (MOS-SF). On the other hand, MI patients reported more headache-related disability (HDI) and were more likely to exhibit disability in physical functioning and role (work) functioning (MOS-SF). CTTH patients were less likely to believe that medical professionals could provide headache relief, were more likely to believe that internal factors could influence their headaches, and had less confidence in their ability to take actions to influence their headaches. Understanding the differences in the burden of headaches and differences in headache beliefs may help in understanding patient-related barriers to treatment. The purpose of this study is to examine the differences in headache impact, psychiatric comorbidity and beliefs about headaches in migraine (MI), chronic tension-type headache (CTTH), and healthy controls (HC). Two-hundred and forty CTTH (78.0% female; 94.6% Caucasian; mean age= 37.04), 209 migraine (80.9% female; 91.4% Caucasian; mean age= 38.33), and 89 healthy controls (77.5% female; 89.7% Caucasian; mean age= 38.02) were administered self-report and interview measures assessing headache impact (Medical Outcomes Study, Short Form; MOS-SF; Headache Disability Inventory; HDI), psychiatric diagnosis (Prime-MD diagnostic interview), and two types of headache beliefs: (a) beliefs about factors that influence headaches and headache relief (Headache Locus of Control; HLOC), and (b) the belief that they could take actions to influence their headaches (Headache Self-efficacy; HSE). Consistent with previous research examining psychological characteristics of headache sufferers, higher levels of impairment and psychiatric comorbidity were observed in both MI and CTTH than in HC. However, the pattern of psychiatric comorbidity and impairment differed in MI and CTTH. CTTH sufferers were more likely to have either an anxiety or mood disorder diagnosis than MI sufferers. Furthermore, CTTH patients were also more likely to report mental health disability, pain-related disability, and perceptions of poorer health (MOS-SF). On the other hand, MI patients reported more headache-related disability (HDI) and were more likely to exhibit disability in physical functioning and role (work) functioning (MOS-SF). CTTH patients were less likely to believe that medical professionals could provide headache relief, were more likely to believe that internal factors could influence their headaches, and had less confidence in their ability to take actions to influence their headaches. Understanding the differences in the burden of headaches and differences in headache beliefs may help in understanding patient-related barriers to treatment.