Impairment in episodic and chronic cluster headache.
Despite being an excruciating headache, little is known about the burden of cluster headache (CH) regarding its various subtypes. In a multicentre, prospective study, patients with chronic CH (n = 27), with episodic CH in the active (n = 26) and outside the active period (n = 22), migraine patients (n = 24) and healthy controls (n = 31) were included. Epidemiological data, the German version of the Headache Disability Inventory (HDI) and a screening for psychiatric complaints were applied. About 25% of chronic CH patients in our study received invalidity allowance due to CH. HDI scores (total and subscales emotion and function) indicated a severe headache-specific disability (one-way ANOVA: P < 0.01). Patients with chronic and active episodic CH were significantly more affected than patients with inactive CH and migraine. Healthy volunteers were significantly less affected than all headache patients. Symptoms suggestive of psychiatric co-morbidity were found predominantly in chronic CH: depressive symptoms (56%), signs of agoraphobia (33%) and suicidal tendencies (25%) were frequently reported. Patients with chronic and active episodic CH were severely impaired in non-economic and economic domains such as disability, working life and psychiatric complaints. Remarkably, psychiatric co-morbidity was highest in chronic CH. Thus, especially chronic CH warrants special medical and further supportive care.
Department of Neurology, University of Regensburg, Regensburg, Germany. t.juergens@uke.de
Tim P
TP
Jürgens
Charly
C
Gaul
Andrea
A
Lindwurm
Thomas
T
Dresler
Yvonne
Y
Paelecke-Habermann
Tobias
T
Schmidt-Wilcke
Ralf
R
Lürding
Karsten
K
Henkel
Elke
E
Leinisch
D000328:Adult; D000379:Agoraphobia / Q000453:epidemiology / Q000523:psychology; D003027:Cluster Headache / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D017281:Cost of Illness; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires