Influence of psychological stress on headache in patients with systemic lupus erythematosus.
OBJECTIVE
To compare the prevalence and disability of headache in patients with systemic lupus erythematosus (SLE) with the general population and to assess the role of chronic psychological stress (CPS) in headache development.


METHODS
One hundred seventy patients with SLE and 102 control subjects matched for age, sex, and level of education were included in this multicenter, cross-sectional study. CPS, headache-related disability, and chronic analgesic intake (CAI) were evaluated in all participants.


RESULTS
No statistical differences in the prevalence of headache between both groups were observed but headache disability was significantly higher in patients with SLE. In addition, a higher average score in the Cohen Perceived Stress Scale (CPSS) and a higher prevalence of patients with CAI were observed in patients with SLE. In multivariate analysis, CPSS score was positively (OR 1.09; 95% CI: 1.03-1.14; p = 0.001) and CAI negatively (OR 0.43; 95% CI: 0.19-0.99; p = 0.049) associated with headache in patients with SLE.


CONCLUSIONS
Despite the prevalence of headache in patients with SLE and the general population being similar, headache-related disability may be higher in patients with SLE. Moreover, CPS might play a role in the pathogenesis of SLE headache, whereas CAI might have a protective effect against it.
From the Systemic Autoimmune Diseases Unit, Internal Medicine Department, the Clinical Analysis Department, and the Department of Statistics, Virgen de las Nieves University Hospital; Occupational Medicine, MAZ Department, Granada; Internal Medicine Department, Asturias Central Hospital, Oviedo; Internal Medicine Department, Carlos Haya University Hospital, Málaga; Internal Medicine Department, San Cecilio University Hospital, Granada, Spain.
José Antonio
JA
Vargas-Hitos
José Mario
JM
Sabio
Isabel
I
Martínez-Egea
Enrique
E
Jiménez-Jáimez
Manuel
M
Rodríguez-Guzmán
Nuria
N
Navarrete-Navarrete
Esther
E
López-Lozano
Ángela
Á
Romero-Alegría
Cristina
C
de la Calle
Laura
L
Jáimez-Gámiz
Pilar
P
Baños-Piñero
Fernando
F
Nebrera-Navarro
Alba
A
Fidalgo
Luis
L
Caminal
Enrique
E
de Ramón Garrido
Norberto
N
Ortego-Centeno
Manuela
M
Expósito
Mónica
M
Zamora-Pasadas
Juan
J
Jiménez-Alonso
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology
HEADACHE; PSYCHOLOGICAL STRESS; SYSTEMIC LUPUS ERYTHEMATOSUS