Coping strategies in episodic and chronic tension-type headache.
OBJECTIVE
To study the importance of coping with illness strategies in tension-type headache (TTH).


BACKGROUND
The pathophysiology of TTH is complex, and coping with illness strategies might contribute to the transformation to a chronic form.


METHODS
We examined 89 subjects (mean age, 45.6 +/- 14.8 years; range, 18 to 72 years) with episodic (n = 37) and chronic (n = 52) TTH. Patients were required to fill in a Freiburg Questionnaire of Coping with Illness (FQCI), a von Zerssen Depression Scale, quality-of-life questionnaires, and a headache home diary (over 4 weeks). In addition, pressure pain thresholds (temporal muscles) and total tenderness scores were obtained.


RESULTS
Patients with chronic TTH exhibited poorer quality-of-life measures, slightly more depressive symptoms, and significantly stronger avoidance behavior and endurance strategies on FQCI scales F4 and F5 (P< .05). There was no difference between episodic and chronic TTH with respect to measures of muscle tenderness or pain thresholds.


CONCLUSIONS
We conclude that disadvantageous coping with illness strategies might contribute to a transformation to chronic TTH.
Department of Neurology and Clinical Neurophysiology, Medical School of Hannover, Germany.
J D
JD
Rollnik
M
M
Karst
M
M
Fink
R
R
Dengler
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000145:classification / Q000150:complications / Q000503:physiopathology / Q000523:psychology*