Two studies of the occurrence of psychophysiological symptoms in chronic headache patients

Abstract

Two separate, but related, studies are described in which psychophysiological symptoms associated with chronic headache were examined. In the first study, the Psychosomatic Symptom Checklist (PSC) was administered to evaluate the presence of 15 different psychophysiological symptoms in 3 types of chronic headache patients (migraine, tension, and combined migraine and tension). Over 97% of these 438 patients reported at least one other symptom occurring at least monthly and 75% reported another intense symptom occurring at least once a week. The tension and combined headache groups reported significantly higher overall symptomatic distress than the migraine headache patients. The tension patients reported significantly higher scores on the backache and weakness items, while the migraine and combined headache patients reported significantly more nausea. The differences between the diagnostic groups is more a function of the intensity of the symptoms than the presence of the symptoms, since, for many individual symptoms, the percentage of patients reporting is nearly equal. In the second study, 150 patients from the original sample (50 from each diagnostic group) were reassesssed using the PSC after psychological treatment of headache. There were significant decreases in total scores for all 3 groups with no significant differences between groups seen at post treatment. Different treatment effects were seen on the individual symptoms with 7 of the 15 showing significant reduction. Chronic headache does not occur in isolation and headache diagnostic groups do not differentiate well on other individual psychophysiological symptoms.