Quality of life in adolescents with migraine and other headaches

In 1975 Ihe research line "Stress and Migraine" was started at the "Free University", Amsterdam. Later this research program was continued at the Institute for Medical Psychology and Psychotherapy, Erasmus University Rotterdam. A first aim of this research line was to investigate the relations between personality traits, perception of stress, and the incidence of migraine and tension-type headache. Physiological mechanisms were studied that can explain how stress may trigger a headache attack. Headache subjects were typified by higher trait and state anxiety levels [1]. They showed a higher degree of achievement motivation and rigidity [2]. However, in a later study [3], no difference in achievement motivation between migraine patients and controls was found. As a possible physiological intermediate between stress and headache, a minor vasodilatation of the superficial temporal arteria could be identified. In a large epidemiological study in adults, Pas schier, Schouten, van der Donk, and Romunde [4] showed that the personality trait of inadequacy is associated with a higher risk of frequent headaches. Additionally, in relatively young subjects (20 through 49 years of age) with frequent headaches, social inadequacy, injuredness, and rigidity were also more often reported than in controls. Another epidemiological study investigated personality variables and stress in relation to headache frequency, duration, and intensity in adolescents with frequent headaches. In this study, stress, school problems, and fear of failure showed a positive relation with headache frequency and intensity [5]. Based on these epidemiological findings, a new study was performed. Here, the effect of relaxation training in groups on headache-intensity and frequency was studied in a school setting. Subjects were between twelve and eighteen years of age. No positive effects of this training on headache were found [6]. However, a broader behavioural treatment program on migraine in adolescents, including biofeedback treatment in a clinical setting, did show a positive effect on headache intensity and frequency [7]. In this study temperature biofeedback in combination with behavioural therapy was the most effective psychological treatment of migraine. Subsequently, another question of research emerged: Do these behavioural treatment programs, besides a positive effect on headache intensity and frequency, also show positive effects on the adolescents' quality of life?

• View at Worldcat

Free Full Text ( Final Version , 3mb )