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Grinberg AS, Best RD, Min KM, Schindler EAD, Koo BB, Sico JJ, Seng EK. Cluster Headache: Clinical Characteristics and Opportunities to Enhance Quality of Life. Curr Pain Headache Rep 2021; 25:65. [PMID: 34668084 DOI: 10.1007/s11916-021-00979-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Cluster headache is a highly disabling primary headache disorder characterized by severe pain and autonomic features. We present the existing body of literature on psychological factors associated with cluster headache and recommendations to address gaps in current clinical care with regards to psychological treatments for cluster headache. RECENT FINDINGS People with cluster headache often endorse depressive symptoms, are more likely than the general population to report suicidal ideation and behaviors, and experience significantly decreased quality of life. Psychological treatments such as Acceptance and Commitment Therapy may be particularly valuable for patients with cluster headache given that they are transdiagnostic in nature and can therefore simultaneously address the disease burden and common psychiatric comorbidities that present. Greater understanding of the debilitating nature of cluster headache and behavioral interventions that seek to reduce the burden of the disease and improve the quality of life of people with cluster headache is paramount.
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Affiliation(s)
- Amy S Grinberg
- Headache Centers of Excellence Research and Evaluation Center, VA Connecticut Healthcare System, West Haven, USA. .,Psychology Service, VA Connecticut Healthcare System, West Haven, USA. .,Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA. .,Neurology Service, VA Connecticut Healthcare System, West Haven, USA.
| | - Rachel D Best
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Kathryn M Min
- Psychology Service, VA Connecticut Healthcare System, West Haven, USA
| | - Emmanuelle A D Schindler
- Headache Centers of Excellence Research and Evaluation Center, VA Connecticut Healthcare System, West Haven, USA.,Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Brian B Koo
- Headache Centers of Excellence Research and Evaluation Center, VA Connecticut Healthcare System, West Haven, USA.,Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.,Neurology Service, VA Connecticut Healthcare System, West Haven, USA
| | - Jason J Sico
- Headache Centers of Excellence Research and Evaluation Center, VA Connecticut Healthcare System, West Haven, USA.,Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Elizabeth K Seng
- Headache Centers of Excellence Research and Evaluation Center, VA Connecticut Healthcare System, West Haven, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA.,Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, New York, USA.,Montefiore Medical Center, Montefiore Headache Center, New York, USA
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Díaz-de-Terán J, Sastre-Real M, Lobato-Pérez L, Navarro-Fernández G, Elizagaray-García I, Gil-Martínez A. Cluster headache, beyond the pain: a comparative cross-sectional study. Neurol Sci 2021; 42:3673-3680. [PMID: 33439388 DOI: 10.1007/s10072-020-04996-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/12/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the presence of allodynia, pain catastrophizing, and the impact of headaches on patients with cluster headache (CH) and healthy individuals. Our second aim was to analyze the relationship between catastrophism, psychological comorbidities, and the impact in CH. METHODS We designed this cross-sectional study to compare various factors among 47 patients diagnosed with CH and 40 healthy controls, and then focus on catastrophism, anxiety, depression, and impact in the CH group. RESULTS There were statistically significant differences between CH and the asymptomatic group in Allodynia Symptom Checklist (ASC) (p < 0.001), Pain Catastrophizing Scale (p < 0.001), and HIT-6 (p < 0.001) scores. We found a correlation among ASC, PCS, anxiety-depression, EuroQoL, and HIT-6 for the CH group. In this group, we observed a strong positive correlation between PCS and anxiety (rho = 0.69; p < 0.001), PCS and depression (rho = 0.62; p < 0.001) and depression and EuroQoL (rho = - 0.68; p < 0.001). The regression model showed that the combination of anxiety and HIT-6 was a significant predictor of PCS (adjusted R2 = 0.52). DISCUSSION Our findings reveal significant differences regarding allodynia, pain catastrophism, and impact in CH group compared with controls. We found a significant relationship between psychological comorbidity, pain catastrophism, and quality of life in CH patients. Anxiety and HIT-6 were a predictor (adjusted R2 = 52%) of pain catastrophism. Screening for these comorbidities should be implemented through a multidisciplinary approach.
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Affiliation(s)
- Javier Díaz-de-Terán
- Department of Neurology, La Paz University Hospital, Madrid, Spain
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Sastre-Real
- Department of Neurology, La Paz University Hospital, Madrid, Spain
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Luis Lobato-Pérez
- Department of Neurology, La Paz University Hospital, Madrid, Spain
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Gonzalo Navarro-Fernández
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain
- Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, C/La Salle, 10, Edificio C, 28036, Madrid, Spain
| | - Ignacio Elizagaray-García
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain
- Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, C/La Salle, 10, Edificio C, 28036, Madrid, Spain
| | - Alfonso Gil-Martínez
- La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain.
- CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, Madrid, Spain.
- Centro Superior de Estudios Universitarios La Salle, Departamento de Fisioterapia, Universidad Autónoma de Madrid, C/La Salle, 10, Edificio C, 28036, Madrid, Spain.
- Unit of Physiotherapy, La Paz University Hospital, Madrid, Spain.
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Mapping Assessments Instruments for Headache Disorders against the ICF Biopsychosocial Model of Health and Disability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010246. [PMID: 33396262 PMCID: PMC7795912 DOI: 10.3390/ijerph18010246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Headache disorders have a strong impact on sufferers’ lives. However, the “content” of assessment instruments addressing concepts, such as disability and quality of life (QoL), has not comprehensively been addressed. We searched SCOPUS for research papers in which outcome measures were used in adult populations of patients with migraine, tension-type headache (TTH), and cluster headache (CH). The content of single instruments was then mapped against the International Classification of Functioning, Disability, and Health. A total of 150 papers and 26 instruments were included: 15 addressed disability or impact, two addressed work-related difficulties, and nine addressed QoL. Few instruments were commonly used across the conditions and covered domains of functioning were impact on daily life activities, homework, school, and work-related tasks, leisure time, informal and family relations, pain, emotional difficulties, energy level, and impulse control. Most of the research is based on instruments that were developed for migraine, which is critical for CH, and the impact of headache disorders on work-related activities is poorly acknowledged. Further research is needed to expand the scope of headaches impact on daily life activities, and on environmental factors relevant to headache disorders to raise knowledge on the less represented areas, e.g., TTH impact.
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Malo-Urriés M, Estébanez-de-Miguel E, Bueno-Gracia E, Tricás-Moreno JM, Santos-Lasaosa S, Hidalgo-García C. Sensory function in headache: a comparative study among patients with cluster headache, migraine, tension-type headache, and asymptomatic subjects. Neurol Sci 2020; 41:2801-2810. [DOI: 10.1007/s10072-020-04384-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
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Rausa M, Cevoli S, Giannini G, Favoni V, Contin SA, Zenesini C, Ballardini D, Cortelli P, Pierangeli G. State and trait anger and its expression in cluster headache compared with migraine: a cross-sectional study. Neurol Sci 2019; 40:2365-2370. [PMID: 31254182 DOI: 10.1007/s10072-019-03987-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/17/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Anger is involved in the emotional experience of pain. Individuals with migraine are more likely to hold their anger-in than controls. However, only one study evaluated anger in cluster headache (CH). The objective is to compare anger between migraine and CH patients. METHODS One hundred thirty-five migraine and 108 CH patients completed the State Trait Anger Expression Inventory (STAXI-2), composed of 7 subscales. State Anger measures the intensity of the individual's angry feelings at the time of testing. Trait Anger evaluates general predisposition to become angry. Anger Expression Out and Anger Expression In measure the extent to which anger could be overtly expressed or suppressed. Anger Control Out and Anger Control In evaluate how individual try to control the outward or inward expression of anger. Anger Expression Index is a general index. RESULTS CH patients have higher median scores than migraine patients in State Anger (46 vs 44, p = 0.012). CH patients have lower scores in Anger Control Out (44 vs 50, p = 0.016). In subgroup analysis, CH patients during the cluster period have higher scores than chronic migraine patients in State Anger (47 vs 44, p = 0.035), while CH patients in headache-free period did not differ from migraine patients. CONCLUSIONS Migraine and CH patients differ in state anger, indicating that CH patients experienced higher intensity of anger during the time of testing. These data add new information about emotional regulation in headache patients and could support the hypothesis of different emotional and behavioral responses to pain in migraine and CH patients.
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Affiliation(s)
- Marialuisa Rausa
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Via Altura 3, 40100, Bologna, Italy. .,Centro Gruber, Diagnosis and Treatment Center of Eating and Weight Disorders, Diagnosis and Treatment of Anxiety and Psychosomatic Disorders, Via Santo Stefano, 10, 40100, Bologna, Italy.
| | - Sabina Cevoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, 40100, Bologna, Italy
| | - Giulia Giannini
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Via Altura 3, 40100, Bologna, Italy
| | - Valentina Favoni
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Via Altura 3, 40100, Bologna, Italy
| | - Sara Anastasia Contin
- Centro Gruber, Diagnosis and Treatment Center of Eating and Weight Disorders, Diagnosis and Treatment of Anxiety and Psychosomatic Disorders, Via Santo Stefano, 10, 40100, Bologna, Italy
| | - Corrado Zenesini
- Neuroepidemiology Research Unit, Servizio di Epidemiologia e Biostatistica, IRCCS-Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40100, Bologna, Italy
| | - Donatella Ballardini
- Centro Gruber, Diagnosis and Treatment Center of Eating and Weight Disorders, Diagnosis and Treatment of Anxiety and Psychosomatic Disorders, Via Santo Stefano, 10, 40100, Bologna, Italy
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Via Altura 3, 40100, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, 40100, Bologna, Italy
| | - Giulia Pierangeli
- Department of Biomedical and Neuromotor Sciences DIBINEM, University of Bologna, Via Altura 3, 40100, Bologna, Italy.,Centro Gruber, Diagnosis and Treatment Center of Eating and Weight Disorders, Diagnosis and Treatment of Anxiety and Psychosomatic Disorders, Via Santo Stefano, 10, 40100, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura, 3, 40100, Bologna, Italy
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