Disability and migraine: MIDAS D’Amico, Domenico; Usai, Susanna; Grazzi, Licia ...
Journal of headache and pain,
09/2001, Letnik:
2, Številka:
S1
Journal Article
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Migraine is an heterogeneous disorder. Most patients are disabled both in work and in non-work activities. Different instruments to assess migraine-related disability have been developed. Among ...these, the migraine disability assessment (MIDAS) questionnaire is the most studied. Population-based studies have shown that MIDAS is a simple but reliable and scientifically sound instrument. This instrument improves patient-physician communication. It can help healthcare professionals to understand migraine severity in individual patients, and rapidly assess treatment needs (screening instrument). Furthermore, reduction in headache-related disability is a major goal of migraine treatment. Change in MIDAS score after treatment intervention may be a useful end point, both in everyday practice and in clinical trials. Ongoing studies will confirm the potential of MIDAS as a valid outcome measure.
A Danish genetic study showed increased risk of cluster headache (CH) among relatives of CH patients. We studied the families of 191 CH patients (118 males, 73 females; mean age 45.9 years) attending ...the Milan Headache Center. Information on 3589 relatives was collected by direct interview of the probands (n = 118) or by mailed questionnaire (n = 73). The diagnostic criteria of the IHS were used. A positive family history was found in 19% (37 of 191) of the families. A total of 32 first-degree (32 of 1036, 3.1%) and 15 second-degree (15 of 2553, 0.6%) relatives were affected. The relative risk of CH was 26.89 (95% CI, 17.57-36.21) in the first-degree relatives and 4.35 (95% CI, 2.13-5.21) in second-degree relatives. This study shows increased familial risk of cluster headache in an Italian population and confirms that cluster headache is, in some families, and inherited disorder.PUBLICATION ABSTRACT
Several papers have been published on the possible risk factors and conditions associated with CH which may provide clues to its underlying etiopathogenesis, including a typical physical appearance ...and peculiar psychological characteristics. The aim of the present study was to evaluate the presence of peculiar somatic and psychological features in CH patients by means of a case-control study. One hundred and twenty CH patients and as many gender- and age-matched controls completed the Minnesota Multiphasic Personality Inventory and underwent 20 cranial and body measurements. The photographs of 71 male subjects (38 cases and 33 controls) were examined by two experienced neurologists who had to decide which subjects were affected by CH. Both cases and controls showed normal personality profiles, without any significant difference emerging between them. None of the head, facial or body measurements differed between cases and controls, except for midface height. The sensitivity and specificity of the patients' pictures for the diagnosis of CH were found by examiner 1 to be 0.71 and 0.67 respectively, and by examiner 2 to be 0.63 and 0.58 respectively. CH patients do not seem to have a peculiar personality profile. While their physiques do not seem to differ substantially from those of the general population, certain skull and/or skin characteristics could lend some patients a typical face appearance.
A multicenter study was carried out in 10 Italian headache centers to investigate the prevalence of anxiety and depression in patients with chronic daily headache(CDH). The study investigated 219 ...patients (171 F; 48 M) including 53 cases of chronic tension-type headache (CTTH), 99 cases of CTTH+ migraine and 67 cases of transformed migraine (TM). The type of headache diagnosed at the beginning was episodic tension-type headache (ETTH, n=32), ETTH + migraine (n=2), CDH ab initio (n=22), migraine with/without aura (n=151), not classifiable migraine (n=7) and not classifiable headache (n=3). The assessment of anxiety and depression was carried out using a Zung self-rating scale for anxiety (Zung A) and for depression (Zung D). The results show that anxiety and depression levels, in each group, were related to sex (F>M). Anxiety, but not depression, was related to the length of chronicization process. Anxiety and depression did not correlate with type of headache at onset, with ongoing headache or, surprisingly, with the abuse of anti-inflammatory drugs. These data suggest the chronicization is a biological and psychological trait.PUBLICATION ABSTRACT
With an ad hoc, previously validated clinical record, we analysed the headache characteristics in 245 patients (F, 78.4%, M, 21,6%; mean age, 43.1±12.9 years) affected by chronic daily headache (CDH) ...attending 9 Italian headache centers. Migraine without aura was the episodic headache preceding CDH in 72.3% of the cases. We divided CDH into 3 categories: chronic tension-type headache (CTTH), chronic coexisting migraine and tension-type headache (CCMTTH), and chronic migraine (CM). CCMTTH accounted for 46.5% of the cases, followed by CM (30.2%) and CTTH (23.3%). Female prevalence was more marked in CCMTTH and CM groups, in which episodic headache started earlier. Migraine without aura was the episodic headache preceding CDH not only in most cases of CCMTTH (83.0%) and CM (91.9%), but also in 25% of CTTH patients. Analgesics misuse (abuse of weak analgesics and/or combination drugs in almost all the cases) prevailed among CCMTTH (61%) and CM (89%) patients with respect to CTTH patients (37%).PUBLICATION ABSTRACT
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