Epidemiological and clinical characteristics with psychosocial aspects of tension-type headache in Turkish college students

We investigated the prevalence and clinical characteristics of tension-type headache (TTH), psychosocial factors contributing to the onset and aggravation of headache and coping mechanisms of individuals in a young population in Turkey. The sample consisted of 2226 university students, aged 7 to 21 years old. A self-administered questionnaire inquiring about epidemiological and clinical features of headache was filled out by participants. TTH diagnosis was determined in accordance with the International Headache Society Criteria of 1988. The prevalence of TTH was 20.35% (25.54% for women and 14.25% for men). 43.7% of headache sufferers had one or more stressful life events before the onset of headache and stress was the most frequent aggravating factor of headache (52%). Resting (58.1%) was the most common coping style. In conclusion, TTH is not a rare condition in Turkish young people and psychosocial factors are always taken into consideration for diagnosis and treatment of TTH.     

Differential predictors of emotional distress in HIV-infected men and women

Changes in the AIDS epidemic in many areas of the United States require information about the experience of the growing segment of women afflicted. This study compared patterns of emotional distress between men and women with symptomatic HIV and examined potential predictors of different levels of vulnerability. A sample of 126 low socioeconomic men and women seeking care from HIV treatment centers was surveyed using measures of physical and psychological well-being. Women had more HIV symptoms, poorer functioning, and greater disruptions in physical and psychosocial well-being. Physical health status and optimism were primary predictors of emotional distress in both men and women. More than 50% of men and women had scores indicative of clinical anxiety. Approximately 1 out of 10 had clinically relevant scores for depression. Gender differences may provide potentially useful information for tailoring assessment interventions for emotional distress in people infected with HIV.     

Prepregnancy Headache and the Well-being of Mother and Newborn

Women (n = 1443) expecting their first child were studied to examine whether prepregnancy headache predicts problems in the well-being of pregnant women and newborns. Subject collection was based on stratified randomized cluster sampling.
Impairment of health during the first trimester was more often reported by women with frequent prepregnancy headache than by nonsufferers. They also made more visits to a doctor and had more pregnancy symptoms during the third trimester. Use of any medication during the first trimester was also more common in the headache group. Mental health status was worse, fatigue and depression increased during pregnancy more often, and stress and anxiety about delivery were more common in this group. The relationship with spouses worsened during pregnancy in the headache group and seemed to be predicted by impairment of somatic health during the first trimester and increasing depression during pregnancy. No statistical differences between groups were found in variables measuring the well-being of the newborns.
Frequent prepregnancy headache proved to be a strong predictor of ill-being in pregnant women. This result should find practical applications in the preventive work of maternity health care clinics.     

Headache and Stress in a Group of Nurses and Government Administrators in Japan

We surveyed a group of 311 nurses and 283 mid-level government administrators in Yamagata Prefecture, Japan, to determine the prevalence and character of their headaches. We investigated the relationship of headaches to the subjects' stress, and their behaviour and coping patterns. The questionnaire we administered explored background factors, as well as the state of the respondents' mental health, life events, work motivation, support system, and interpersonal relationships.
The questionnaire was completed by 76.8% of nurses and 100% of administrators. Of these, 40.6% of nurses and 19.1% of the administrators reported recurrent headaches Furthermore, the number of headache sufferers among the women administrators was significantly higher than in the men. The nurses and the administrators who reported headache scored significantly higher than the nonheadache groups on the questions measuring symptoms of burnout, General Health Questionnaire, and learned helplessness. The group of nurses with headache had higher scores for life events, decreased work motivation. and nervous behavior than the nonheadache group; the administrators with headache scored higher for daily hassles than those of the nonheadache groups. In this study of a Japanese sample, the character of the subjects' headache and the possible inducing factors are consistent with those reported in studies of Europeans and Americans using similar testing methods. However, the high prevalence of headache among nurses and women administrators seems to be related to psychological stress, particularly work stress, which may be characteristic in Japan.     

Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health

BACKGROUND: Much attention has been paid to the problem of postpartum depression in women. However, there is some indication that men also experience depression after the birth of a child, and that paternal depression is linked to maternal depression. AIMS: The purpose of this integrative review was to examine current knowledge about postpartum depression in fathers. Specific aims were (1) to examine the incidence of paternal depression in the first year after the birth of a child, (2) to identify the characteristics and predictors of paternal postpartum depression, (3) to describe the relationship between maternal and paternal postpartum depression, and (4) to discuss the influence of paternal depression on the family and infant. METHODS: A literature search from 1980 to 2002 was carried out using the CINAHL, PsychInfo, and Medline electronic databases. Twenty research studies were identified that included incidence rates of paternal depression during the first year postpartum. These were further examined and synthesized regarding onset, severity, duration, and predictors of paternal depressive symptoms, and for information about the relationship between maternal and paternal depression. FINDINGS: During the first postpartum year, the incidence of paternal depression ranged from 1.2% to 25.5% in community samples, and from 24% to 50% among men whose partners were experiencing postpartum depression. Maternal depression was identified as the strongest predictor of paternal depression during the postpartum period. The implications of parental depression for family health were discussed. CONCLUSIONS: Postpartum depression in men is a significant problem. The strong correlation of paternal postpartum depression with maternal postpartum depression has important implications for family health and well-being. Consideration of postpartum depression in fathers as well as mothers, and consideration of co-occurrence of depression in couples, is an important next step in research and practice involving childbearing families.     

Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population

We conducted a cross-sectional survey of 12,988 subjects aged 20–79 years (5,908 men and 7,090 women) receiving health checkups at a Tokyo clinic. They filled out a self-administered structured questionnaire, and 5.4% of the men and 15.4% of the women reported having headaches. Younger subjects were more prone to having headaches. The likelihood of having headaches increased with stress level and decreased ability to relieve stress in both genders. There was an inverse dose–response relationship between having headaches and alcohol consumption, and less walking/exercise and sleep problems increased the likelihood of headaches in both genders. Headache sufferers of both genders were more likely to report multiple additional poor health conditions. A multivariate stepwise logistic analysis showed that age, self-estimated degree of stress, reported number of additional poor health conditions, and less alcohol consumption were independently correlated with having headaches. In conclusion, although women were more susceptible to headache, Japanese men and women in Tokyo shared factors associated with headache, including age, stress, having other poor health conditions, alcohol consumption, sleep, and exercise.     

Effect of psychosocial factors on metabolic syndrome in male and female blue‐collar workers

Aim: The purposes of this study were to examine the relationship between psychosocial factors and metabolic syndrome among male and female blue‐collar workers, and which factors influence their metabolic syndrome by sex. Methods: A cross‐sectional study was completed of 154 men and 80 women working at small companies in Korea. The data were collected through a structured questionnaire, blood test, and anthropometric and blood pressure measure. Metabolic syndrome was diagnosed from the results of blood test and the measurements of waist circumference and blood pressure. Results: The prevalence of metabolic syndrome among male and female blue‐collar workers was 24.0% and 7.5%, respectively. Multiple logistic regression analysis was performed to examine factors of metabolic syndrome associated with sex. After controlling for age, marital status, smoking, alcohol drinking, shift work, overtime work, and physical exercise, job stress (odds ratio [OR] = 3.10, P = 0.005) and risk perception (OR = 1.12, P = 0.016) were influencing factors for men, and low job stress (OR = 0.05, P = 0.04), low social support (OR = 1.51, P = 0.009), and risk perception (OR = 1.27, P = 0.023) for women. Conclusion: Metabolic syndrome among blue‐collar workers is closely related to psychosocial factors, such as job stress, social support, and risk perception, with the effect of job stress a point of difference between men and women. Occupational health nurses should be cognizant of the importance of assessing the effect of psychosocial factors on cardiovascular risk for blue‐collar workers.     

Psychiatric comorbidity and psychosocial stress in patients with tension-type headache from headache centers in Italy. The Italian Collaborative Group for the Study of Psychopathological Factors in Primary Headaches

A multicenter study was carried out in 10 Italian Headache Centers to investigate the prevalence of psychosocial stress and psychiatric disorders listed by the IHS classification as the "most likely causative factors" of tension-type headache (TTH). Two hundred and seventeen TTH adult outpatients consecutively recruited underwent a structured psychiatric interview (CIDI-c). The assessment of psychosocial stress events was carried out using an ad hoc questionnaire. The psychiatric disorders that we included in the three psychiatric items of the fourth digit of the IHS classification were depressive disorders for the item depression, anxiety disorders for the item anxiety, and somatoform disorders for the item headache as a delusion or an idea. Diagnoses were made according to DSM-III-R criteria. At least one psychosocial stress event or a psychiatric disorder was detected in 84.8% of the patients. Prevalence of psychiatric comorbidity was 52.5% for anxiety, 36.4% for depression, and 21.7% for headache as a delusion or an idea. Psychosocial stress was found in 29.5% of the patients and did not differ between patients with and without psychiatric comorbidity. Generalized anxiety disorder (83.3%) and dysthymia (45.6%) were the most frequent disorders within their respective psychiatric group. The high prevalence of psychiatric disorders observed in this wide sample of patients emphasizes the need for a systematic investigation of psychiatric comorbidity aimed at a more comprehensive and appropriate clinical management of TTH patients.     

Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel

This study aimed at investigating the relationships between work-related psychosocial factors, worry about work conditions and health complaints (sleeping problems, headache and stomach symptoms) among female and male ambulance personnel. Out of 4000 ambulance personnel in Sweden, 1500 (300 female and 1200 male personnel) were randomly selected. They answered a questionnaire including items on self-reported health complaints, individual characteristics, work-related psychological demands, decision latitude, social support and worry about work conditions. Twenty-five per cent of the female and 20% of the male ambulance personnel reported two or more health complaints sometimes or often. According to the demand-control-support questionnaire, ambulance personnel reported a generally positive psychosocial work environment, although psychological demands were associated with sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Another factor that was significantly associated with health complaints among both genders was worry about work conditions. When worry about work conditions was added to the regression models, this variable took over the role from psychological demands as a predictor for health complaints among the female ambulance personnel. The prevalence of sleeping problems, headache and stomach symptoms were significantly associated with psychological demands among both female and male ambulance personnel. Notably, worry about work conditions seems to be an important risk factor for health complaints. This suggests that worry about work conditions should not be neglected when considering risk factors among ambulance personnel.     

Postpartum depression and related psychosocial variables in Hong Kong Chinese women: findings from a prospective study

Research on predictors of postpartum depression (PPD) in Hong Kong (HK) Chinese women is scant. A prospective study with 385 HK Chinese postpartum women was conducted to identify correlations between PPD and demographic variables, and antenatal depression and psychosocial variables, and to determine which of these variables were predictors of PPD. Using the Edinburgh Postnatal Depression Scale (EPDS), we classified 19.8% of participants as postnatally depressed. Fifty-six percent of the variance in PPD was explained by social support and stress factors. However, social support factors accounted for only a small percentage of that variance. The major predictors were antenatal depression, postnatal perceived stress, and childcare stress. HK women may benefit from a culturally appropriate intervention focused on reducing stress in the postpartum period.     

Psychosocial Factors and Prediction of Headaches in College Adults

The current study evaluated psychosocial variables that may contribute to the experience of headache in college adults. One hundred ninety-nine participants, 103 women and 96 men, completed head pain logs for 4 weeks after completing measures assessing psychosocial variables. Multiple regression analyses indicated that level of emotional functioning, perception of stress, and gender were predictive of future headache frequency, intensity, and duration. Family history and health habits did not predict headache activity. These findings are consistent with research investigating psychosocial variables and headache activity.     

Pediatrics (78)

Pain experience of children with headache and their families: a controlled study. (University of Turku, Turku, Finland) Pediatrics 2000;106:270–275. This study reported the pain sensitivity of children with headache and their family members as well as the prevalence of recurring aches, psychosocial life, and family environment of children with headache at preschool age. A representative population‐based sample of 1443 families expecting their first child was followed over 7 years. A screening questionnaire relating to the child's headache was sent to parents of a representative sample of 1132 6‐year‐old children. Of 144 children suffering from headache, 106 (76%) were examined and interviewed clinically. Ninety‐six children (58 migraine and 38 tension‐type headache children) with primary headache and matched controls were included in further examinations. Children with headache were more often extremely sensitive to pain according to their parents, were more excited about physical examinations, cried more often during blood sampling or vaccination, avoided play or games more often because they were afraid of hurting themselves, and had recurring abdominal and growing pains more often than did control children. The fathers of children with headache were more often extremely sensitive to pain. Children with headache reacted with somatic symptoms, usually with pain and functional intestinal disorders in stress situations, felt more tired, and had more ideations of death during the previous month. More mothers of tension‐type headache children than those of migraine children reported that they were considerably sensitive to pain. Tension‐type headache children had a poorer family environment; the family atmosphere was more often unhappy and the relationship between parents was more often distant than in families of children with migraines. Conclude that in addition to somatic factors, it is important to consider the child's pain sensitivity, reaction to various stress situations, and family functioning when studying childhood headache. The child's coping mechanisms can be supported by information given by the parents. School entry can be considered a suitable period for careful investigation into possible occurrence of headache and also for giving information about headache and its management     

The effect of psychosocial risk factors on postpartum depression in antenatal period: A prospective study

PurposeThe aim of this study was to determine the psychosocial risk factors that may increase the risk of developing postpartum depression (PPD) symptoms in the antenatal period at postpartum 6–8 weeks.MethodsThis study was a prospective longitudinal design, in which women completed questionnaire measures both at the third trimester of pregnancy and 6–8 weeks after birth. The present study was conducted in the women's clinic of a Medical Faculty Hospital in the Central Anatolia region of Turkey between March 15 and August 15, 2019. A total of 245 pregnant women in the third trimester were included in the study. Data were collected using a sociodemographic and obstetric data collection form, Pregnancy Psychosocial Health Assessment Scale, Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Edinburgh Postnatal Depression Scale.ResultsForty-four (18%) of the 245 women had scores above the cut-off point (>13) in EPDS. Being subjected to violence from husband or another male member of the family during pregnancy, having problems in marriage, depression, anxiety, and high levels of perceived stress affect the risk of developing PPD by 55% (χ² = 101.034, P < 0.001). It was observed that those who scored low on the psychosocial health scale, those who experienced unplanned pregnancy, those with pregnancy that was not wanted by the husband, those who were emotionally abused, and those who experienced a sad event in their families were more sensitive to PPD symptoms.ConclusionsPsychosocial health, perceived stress, and psychosocial risk factors, such as depression and anxiety, during pregnancy are important determinants of postpartum depressive symptoms.     

The Prevalence of Headache in a Small New Zealand Town

SYNOPSIS
Information on the prevalence, characteristic features and possible causative factors of headache was collected from 1138 adults who participated in a multiphasic health survey in Milton in May 1981.
Thirty-nine percent of men and 60% of women experienced headaches in the year preceding the survey. Total prevalence of headache peaked in men 30–39 years and in women aged 20–29 years and thereafter decreased with increasing age.
The most commonly reported positions for headache were at the forehead unilaterally and bilaterally. The most common precipitating factors were 'too much' alcohol (men only), tiredness, mental stress and eye strain. Chocolate was the food most commonly blamed for the headache.
No association was found between headache frequency and blood pressure or smoking habit. However the psychometric scores for anger, anxiety and depression were positively related to frequency of headache.     

Gender differences in treatment-seeking chronic headache sufferers

OBJECTIVE: To identify gender differences within a group of patients seeking treatment for chronic headache. Previous studies of the general population have reported differences in headache symptoms, frequency, disability, and psychological distress, with women affected with more severe and disabling symptoms than men. This study evaluated these features in a population seeking treatment. METHODS: Two hundred fifty-eight consecutive patients with headache attending a university headache clinic were evaluated with questionnaires about headache symptoms and psychological distress. Comparisons between men and women were made for headache symptoms, severity, frequency, trigger factors, comorbid depression and anxiety, and response to treatment. RESULTS: There were no gender differences in headache symptoms, frequency, severity, and duration. Headache triggers were gender-specific, with men more likely to endorse exercise and women more likely to endorse stress and exposure to odors. Psychological comorbidity was similar among men and women seeking treatment, with a mean Beck Depression Inventory score of 10 and a mean Spielberger trait anxiety score of 39 for both men and women. Disability was greater in men, with 46% reporting restrictions in activities more than 3 days per week because of headache compared with 29% of women. In addition, men were more likely to contribute headache control to external figures than women. CONCLUSIONS: Patients seeking treatment for chronic headache do not have the same gender-specific differences that have been reported in general population surveys. Men who seek treatment for headache are more likely to have significant disability, and are equally likely to have symptoms of depression and anxiety as women who seek treatment. Clinical and research investigations of headache triggers need to be gender-specific.     

The immigrant patient having widespread pain. Clinical findings by physicians in Swedish primary care

AIM. Do the clinical findings explain the complaints of longstanding demonstrated widespread pain (DWP) in a group of immigrant patients, or not? SUBJECTS. Consecutive immigrant patients, on long-term sick leave, aged 18 - 45, at a primary healthcare centre in Stockholm, Sweden. METHODS. Interpreters were available. Two primary care physicians jointly, made a somatic status and diagnosed tender-structure locations (> or =3 tender-structure locations or less) and depression (yes or no), and assessed psychosocial stressors (little or much) and pain-related anxiety (yes or no). The patients pointed at their pain parts. This was transferred by one of the doctors to a pain drawing with 18 fields. Five or more fields were defined as DWP. Non-parametric tests were used to detect significant differences between the DWP and non-DWP groups. Cumulative frequencies of the following four categories of explanatory variables of DWP were counted: > or =3 tender-structure locations (could also include the other variables), much psychosocial stress (could include depression and pain-related anxiety), depression (could include pain-related anxiety), or pain-related anxiety alone. RESULTS. Many of the 49 men and 100 women, on average 38 years, spoke little or no Swedish. A fifth of the men (n = 10) and half (n = 56) of the women had DWP. These men often had much stress (p < 0.01) while the women had > or =3 tender-structure locations (p < 0.001). DWP among men was explained to 100% by: > or =3 tender-structure locations (30%), much psychosocial stress (60%), or depression alone (10%). DWP among the women was explained to 96 cum. % by: > or =3 tender-structure locations (59%), much psychosocial stress (25%), or pain-related anxiety alone (13%). CONCLUSION. Demonstrated widespread pain was nearly always explained by clinical findings, and especially by numerous tender-structure locations in women. There is a need for more studies among men.     

Life event stress and headache frequency revisited

Life stress is found to be related to headache frequency in some studies, but not others. Research designs that find a relationship between the two tend to evaluate young subjects and employ large sample sizes. The purpose of this study was to evaluate the relationship between headache frequency and life stress, while considering gender and age differences that may be present in the relationship. In addition, as depression or presence of headache at the time of assessment may influence the report of headache frequency, an attempt to control for these factors was employed. Several self-report measures of headache symptomatology, headache presence, depression, and life stress were completed by 1289 subjects. Negative life event stress was found to be modestly but significantly related to headache frequency. The relationship between the 2 variables was stronger for women than for men and, after the influence of depression and headache state was removed, the relationship between life stress and headache frequency remained significant only for women. In the oldest 10% of the sample, there was no evidence of a relationship between negative life event stress and headache frequency.     

Stress, health complaints and self-confidence: a comparison between young adult women in Sweden and USA

Transition to adulthood is a period in life when women encounter conflicts, ambiguities and rapidly expanding roles that may be stressful and difficult to manage. The aim of this study was to compare stress in daily life, health complaints and self-confidence in 26-year old women in two different cultures. A health survey study was performed among Swedish women (n = 386) and American women (n = 201) living in urban areas at the West coast of Sweden and in Minnesota. Both Swedish and American women reported stress in their everyday life, with higher figures for the Americans. Overall health was rated lower by the Swedish women and they reported more health complaints such as headache, general tiredness, irritability, depression and sleeping disorders. There was a difference between groups in self-confidence with higher figures for excellent self-confidence among American women. However, low self-confidence was reported by more American than Swedish women. A good work situation predicted self-confidence in Swedish women and financial confidence in American women. Physical fitness was associated with self-confidence in both groups. Young women in both cultures experienced high level of stress but health related complaints were more common among Swedish women. High stress and health complaints must be taken seriously and interventions to support young women in the midst of transition to adulthood should contain stress reduction as well as empowerment performed in a more effective way than today in different health care settings and at place of work.     

The complexity of postpartum mental health and illness: a critical realist study

The complexity of postpartum mental health and illness: a critical realist study Postpartum depression (PPD) is a major public health issue that profoundly impacts the woman, her infant and family. Although it may be linked to hormone changes, no direct hormonal aetiology has been established. A large body of evidence implicates numerous psychosocial predictors of PPD. While a history of depression predicts about 50% of cases of PPD, it remains unclear why some women with a history do not develop depression following childbirth, even taking psychosocial factors into account. The aim of this study was to identify the main mechanisms and factors associated with the presence or absence of PPD in women with a history of depression, and the presence of PPD in women without a history, using a critical realist approach. The findings indicate a number of personal and contextual factors that influence postpartum mental health and illness. In addition, and perhaps most importantly, women who did not develop depression identified goal-oriented actions that were protective. These factors and processes did not exist in isolation and the interplay among them in influencing health was apparent. More research is needed to explore the effects of these mechanisms in different contexts.     

Socio-economic factors, lifestyle, and headache disorders - a population-based study in Sweden

Objective.— To study the association between socio‐economic factors, lifestyle habits, and self‐reported recurrent headache/migraine (RH/M) in a general population. Methods.— The study population comprised a random sample of men and women aged 18‐79 years. The data were obtained using a postal survey questionnaire during March‐May 2000. The overall response rate was 65%. The area investigated covers 58 municipalities with about one million inhabitants in central part of Sweden. The study is based on 43,770 respondents. Odds ratios for RH/M were calculated for a set of variables using multiple logistic regression models. Results.— The overall prevalence of self‐reported RH/M during the last 3 months was 10% among men and 23% among women and decreased with increasing age. Physically inactive subjects were more likely to suffer from headache disorders than physically active subjects. Smoking was only moderately associated with RH/M. There was an inverse relationship between heavy alcohol use and RH/M. Underweight and obesity were not associated with headache disorders when adjusted for socio‐economic factors. Subjects with frequent economic problems had almost twice the risk of RH/M compared with subjects with no economic problems. Poor social support was associated with headache disorders and subjects who had been belittled during the last 3 months were more than twice as likely to suffer from RH/M as subjects who had not been belittled. The effect of educational level was modest. Marital status and country of origin were not associated with headache disorders after adjustment for other socio‐economic factors. Dissatisfaction with work, worry about losing one's job, and absenteeism due to illness were strongly associated with headache disorders. Physical working conditions and working hours were not associated with RH/M. Conclusion.— Headache disorders mainly affect young and middle‐aged adults. There are, however, socio‐economic disparities in self‐reported recurrent headache and migraine. The relationship was particularly evident for economic hardship and psychosocial factors. Of lifestyle factors, physical inactivity was strongly associated with headache disorders independent of economic and psychosocial factors.