Headache and family history

In two headache questionnaire surveys we inquired about the occurrence of headache in the mothers, fathers, siblings and children of the respondents. In total, 633 people completed valid questionnaires, 260 in the first survey and 373 in the second. The hypothesis was that familial headache occurrence would be positively associated with headache frequency. In each survey, the regression of headache frequency on the number of parents having headache was highly significant. Neither sex nor the sibling and children variables were significant predictors. In the cross-tabulations of the parental occurrence of headache with headache frequency we saw a clear "break-point" between the "no headache" and the headache frequency categories studied. For the final analyses the dichotomy "headache/no headache" was related in fourfold tables to headache occurrence in the father and the mother separately, and to the number of headache parents. The positive associations were not simply due to the large number of migraine cases since they remained after removing the migraineurs.     

Headache and cardiovascular risk factors: positive association with hypertension

The study analyzes the prevalence of cardiovascular risk factors in 1343 patients with severe headache (399 men and 944 women), aged 15 to 64 years; analyses were controlled for sex, age, and type and frequency of headache. Prevalence of various forms of headache was different between men and women. Age and days per year with headache were significantly different among various forms of headache. For men and women with headache, age directly related to prevalence of hypertension, hypercholesterolemia, and obesity. Due to low prevalence, analyses by age were not done for diabetes mellitus. For cigarette smoking, prevalence was not related to age in men, but was inversely related to age in women. With control for age, prevalence of cardiovascular risk factors was not significantly different among patients with different forms of headache, except for cluster headache. Among men with cluster headache, prevalence was high for cigarette smoking, but low for hypercholesterolemia. With control for age, days per year with headache did not relate to prevalence of cardiovascular risk factors except for cigarette smoking in men. Compared to data for a population sample used as control, patients with headache had higher prevalence of hypertension in both sexes, independent of age (odds ratio 1.51, 95% confidence interval 1.28 to 1.80); the difference between patients with headache and the control population was lower with increasing age. The high prevalence of hypertension among patients with headache was not due to overweight. The data indicate that headache is significantly associated with hypertension, but not with other cardiovascular risk factors.     

Headache and other types of chronic pain

OBJECTIVE: To compare pain severity, disability, psychological distress, and quality of life between patients with headache and nonheadache treatment-seeking chronic pain patients. METHODS: Six hundred forty-three patients seeking treatment at a university pain clinic were divided into 3 categories based on primary pain complaint and the presence of focal or diffuse pain complaints: headache, nonheadache focal (pain involving <50% of the body), and nonheadache diffuse (pain involving >/=50% of the body). Patients completed questionnaires to identify pain severity, disability, depression, anxiety, and quality of life. RESULTS: Patients with headache differed from nonheadache patients for all evaluated parameters. Average pain severity on a 0 to 10 point severity scale was 5.55 for headache, 6.93 for nonheadache focal, and 8.05 for nonheadache diffuse. Pain occurred an additional 1.51 to 1.71 days per week for patients without headache. Compared to patients with headache, patients without headache reported greater frequency of reduced daily activities and complete disability related to pain. In addition, patients without headache and with diffuse pain reported more depression (78.2% vs. 45.8%) and anxiety (70.0% vs. 39.1%) than patients with headache. Quality of life measures were significantly reduced in patients with either nonheadache focal or diffuse conditions compared to patients with headache. CONCLUSIONS: Even when considering patients with focal rather than diffuse chronic pain complaints, patients with headache are dissimilar from other patients with chronic pain. Pain severity, frequency, disability, psychological distress, and quality of life are significantly more prominent or impaired in patients with chronic pain without headache compared to patients with headache.     

Behavioral and psychosocial factors associated with insomnia in adolescents with chronic pain

This study aimed to (1) identify differences in sleep behaviors, sleep quality, pre-sleep arousal and prevalence of insomnia symptoms in adolescents with chronic pain compared to a healthy age and sex-matched cohort and (2) examine pain intensity, pubertal development, depression, and pre-sleep arousal as risk factors for insomnia symptoms. Participants included 115 adolescents, 12-18 years of age (73.0% female), 59 youth with chronic pain and 56 healthy youth. During a home-based assessment, adolescents completed validated measures of pain, sleep quality, sleep hygiene, pre-sleep arousal, depressive symptoms, and pubertal development. Findings revealed a significantly higher percentage of adolescents with chronic pain reporting symptoms of insomnia (54.2%) compared to healthy adolescents (19.6%), p < .001. Youth with chronic pain also reported higher cognitive and somatic arousal at bedtime, and lower sleep quality compared to the healthy cohort. In a logistic regression, two factors emerged as significant predictors of insomnia, having chronic pain (OR = 6.09) and higher levels of cognitive pre-sleep arousal (OR = 1.24). Level of pain intensity did not predict insomnia. While sleep disruption may initially relate to pain, these symptoms may persist into a separate primary sleep disorder over time due to other behavioral and psychosocial factors. Assessment of insomnia may be important for identifying behavioral targets for the delivery of sleep-specific interventions to youth with chronic pain.     

Headache syndromes amongst schoolchildren in Riyadh,Saudi Arabia

We evaluated 1,400 randomly selected Saudi children in grades 1 through 9 to determine the prevalence of migraine and tension-type headache. Of the 1400 distributed questionnaires, 1,181 (84.3%) were completed properly and so served as the basis for analysis. There were 573 boys (48.5%) and 608 girls (51.5%). Ages ranged from 6 to 18 years. Five hundred eighty-eight children (49.8%; 272 boys and 316 girls) had recurrent headache episodes not related to febrile illness in the year preceding the survey. Eighty-four children (7.1%; 37 boys and 47 girls) had recurrent episodes of migraine, and 504 (42.7%; 232 boys and 272 girls) had recurrent episodes of nonmigraine headache. For both boys and girls, the age-specific prevalence rate for nonmigraine headache rose steadily from around 15% at aged 6 to 7 years to nearly 60% after aged 15. For migraine, there was a sharp increase in the prevalence rate (from around 2% to around 9%) at aged 10 to 11, also in both boys and girls. Age-adjusted prevalence for migraine between aged 6 and 15 was 6.2%. Due to the relatively poor sensitivity of some of the IHS criteria in children, this figure may underestimate the true magnitude of migraine in the population studied.     

Headache children with temporomandibular disorders have several types of pain and other symptoms

The aim was to investigate the association between temporomandibular disorders (TMD) and overall muscle tenderness, depressive symptoms, sleep difficulties, headache frequency and related symptoms in children with primary headache in comparison with controls. Based on an unselected population sample of 1135 Finnish schoolchildren classified according to the type of headache at age 12, altogether 297 children aged 13–14 from different headache groups and healthy controls were randomly selected for an interview and clinical examinations. Children with migraine had more TMD signs than children with nonmigrainous headaches or healthy controls. High TMD total scores were associated with palpation tenderness in other parts of the body and with frequent headache attacks. We conclude that children with overall headache, migraine in particular, and high total TMD scores showed an increased overall tenderness to muscle palpation and multiply manifested hypersensitivity pain.     

Risk factors for and sequelae of headaches in schoolchildren with clinical implications from a psychosocial perspective

Functional headache, by definition, is a headache not associated with organic diseases. It is a common symptom in school children and can cause potentially serious health problems, affecting their growth and development. Therefore, this report synthesizes the literature about functional headaches in schoolchildren from a psychosocial perspective. This report examines the research on risk factors and sequelae of headaches in children, presents a framework to guide the conceptualization of this phenomenon, and suggests an application of this framework for clinical practice.     

The association between cognitive factors,pain and disability in patients with idiopathic chronic neck pain

Purpose.?The aim of this study was to establish the relationship between known cognitive factors and levels of pain and disability in patients with idiopathic chronic neck pain.

Method.?Ninety-four patients referred for physiotherapy because of chronic neck pain completed measures of pain, disability, catastrophising, pain-related fear, pain vigilance and awareness and self-efficacy beliefs. Hierarchical multiple regression analyses were then performed to establish whether the cognitive factors were significant determinants of levels of pain and disability.

Results.?The cognitive measures were significantly related to levels of pain and disability, explaining 23% of the variance in pain intensity and 30% of the variance in disability. Specifically, greater catastrophising (β?=?0.37, p?<?0.05) and lower pain vigilance and awareness (β?=???0.32, p?<?0.05) were associated with greater pain intensity. Moreover, greater catastrophising (β?=?0.26, p?<?0.05) and lower functional self-efficacy beliefs (β?=???0.34, p?<?0.001) were significantly associated with greater levels of disability.

Conclusions.?Cognitive factors were strongly related to levels of pain and disability in patients with chronic neck pain. In view of this, targeting the modification of these cognitive factors should be an integral part of therapy when treating patients with idiopathic chronic neck pain.     

The association between postural alignment and psychosocial factors to upper quadrant pain in high school students: A prospective study

Prolonged sitting and psychosocial factors have been associated with musculoskeletal symptoms among adolescents. However, the impact of prolonged static sitting on musculoskeletal pain among South African high school students is uncertain. A prospective observational study was performed to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain (UQMP) in grade ten high school students working on desktop computers. The sitting postural alignment, depression, anxiety and computer use of 104 asymptomatic students were measured at baseline. At three and six months post baseline, the prevalence of UQMP was determined. Twenty-seven students developed UQMP due to seated or computer-related activities. An extreme cervical angle (<34.75° or >43.95°; OR 2.8; 95% CI: 1.1–7.3) and a combination of extreme cervical and thoracic angles (<63.1° or >71.1°; OR 2.2; 95% CI: 1.1–5.6) were significant postural risk factors for the development of UQMP. Boys with any extreme angle were more likely to suffer pain compared with boys with all middle range angles (OR 4.9; 95% CI: 1.0–24.5). No similar effect was found for girls. There was no strong relationship between depression, anxiety, computer exposure and UQMP among South African high school students.     

Familial pain models: the relationship between family history of pain and current pain experience

Recent evidence has underscored the importance of parental models and vicarious learning in the etiology of pain behavior. The present study investigated the relationships between the number of familial pain models to which an individual has been exposed, the individual's reports of current pain experiences, and the role of gender. One hundred and twenty male and 168 female college students reporting occasional pain episodes completed the Parameters of Pain Questionnaire. Results indicated that a significant positive relationship exists between the number of pain models in an individual's familial environment and the frequency of his/her current pain reports. Additionally, pain models had a greater impact on females than on males. These findings are discussed in terms of vicarious learning and health locus of control processes.     

Do psychosocial factors moderate the association of fixed-term employment with work interference with family and sleeping problems in registered nurses: A cross-sectional questionnaire survey

Background

The use of fixed-term employment has increased lately, particularly in Europe and in the health care sector. Previous studies have shown that especially among the health care sector employee's organizational justice perceptions and job control are important factors that are directly related to the welfare and attitudes of employees and may also help to buffer the negative impacts of many detrimental factors.

Objective

The present study examined the association of employment type (fixed-term vs. permanent) with work interference with family (WIF) and sleeping problems. In addition, we examined whether organizational justice and job control were able to moderate above-mentioned associations.

Design

Cross-sectional study design.

Setting

A random sample of registered nurses in Finland from the Central Register of Health Care Professionals.

Participants

1767 Finnish registered nurses (1676 women and 91 men) aged 23-60 years (mean = 42.6, SD = 10.0) formed a final study sample.

Methods

The relationships were studied by linear regression analyses and the effects of gender, age, marital status, employment sector, work shift, number of children, and overtime work hours were adjusted for.

Results

Our results showed that organizational justice moderated the association between employment type and WIF. That is, those employees who were employed in fixed-term contracts and experienced low levels of organizational justice had higher levels of WIF than others. Employment type was not directly associated with WIF or sleeping problems. High justice levels were directly associated with less WIF and less sleeping problems, and high job control levels with less sleeping problems.

Conclusion

According to our results it would be important to promote fair organizational procedures and management in the health care sector especially for those who are employed with fixed-term contracts and in organizations with a lot of fixed-term employees.     

Low back pain in adolescent and associated factors: A cross sectional study with schoolchildren

Objective:

To determine the prevalence of low back pain nonspecific and associated factors in schoolchildren.

Method:

This cross-sectional study investigated 343 adolescents, aged between 12 and 15 years, of both sexes of public schools. The questionnaire included questions regarding sociodemographic characteristics, type of school transportation, body mass index and low back pain. The outcome was defined as discomfort localized below the costal margin and above the inferior gluteal folds in the last 12 months.

Results

: The prevalence of low back pain in the last year was 57% (n=195) among participants, with no significant difference between the sexes (OR 1.13, 95% CI 0.93 to 1.37). Advancing age and body mass index were associated with the presence of low back pain in the bivariate analysis. The remaining seated at school in usual days was considered one of the main activities that trigger symptoms that lasted up to seven days for the majority (80%) of adolescents.

Conclusions:

The high prevalence of low back pain presented, indicating that it is a common condition among these adolescents. There was no difference between the sexes, but had influence of age and body mass index. Our results point to the need for the development epidemiological studies of low back pain among children and adolescents.     

Carer experience of back pain is associated with adolescent back pain experience even when controlling for other carer and family factors

OBJECTIVES: The study objectives were (1) to determine if adolescent back pain is related to carer back pain; and (2) to examine whether other carer and family factors accounted for any such relationship. METHODS: Back pain experience was collected independently from 1608 fourteen-year-old adolescents and their care givers by questionnaire. Measures of back pain impact on carers were also collected (modified activities, missed work, sought professional help, took medication). Other carer factors examined were age, sex, smoking habits, depression, anxiety, and stress. Familial factors examined included income, stressful events, and family functioning. Odds ratios were calculated to describe familial associations with multivariate modeling used to examine the influence of other carer and family factors. RESULTS: Lifetime prevalence of back pain was 46.5% for adolescents and 72% for their carers. Having a carer with back pain increased the risk of back pain for adolescents, and this was magnified if both carers had back pain (odds ratio 1.61). Adolescent back pain was not associated with primary carer age, sex, depression, anxiety, or stress but was related to family stressful events. However, these other factors did not diminish the association between carer back pain and adolescent back pain. DISCUSSION: Carer experience of back pain is clearly associated with adolescent experience of back pain. Although other carer and family factors are also associated, the carer's back pain experience is not a surrogate measure of these other factors suggesting other genetic and behavioral mechanisms may be important for adolescent back pain development.     

Headache in schoolchildren: agreement between different sources of information

The level of agreement between different sources of information, i.e. questionnaires, interviews and diaries, was evaluated in a sample of 129 schoolchildren, 69 girls and 60 boys, ranging in age from 7 to 17 years. Headache diagnoses and headache features showed high agreement between questionnaires and subsequent interviews. The concordance between questionnaires and interviews for headache diagnoses increased, and the number of unclassified headaches decreased, when the International Headache Society (IHS) duration criterion was excluded. When comparing headache frequency reported in questionnaires and interviews with diary recordings, the agreement was low and the frequency higher in the diaries. Overall, the agreement between questionnaires, interviews and diaries was not related to age or gender. The questionnaire may serve as a valid source of information in studies of headache in schoolchildren. Prospective recordings in diaries provide additional information, in particular of low-intensity headache. In children, the IHS duration criterion should be modified or excluded.     

Cancer pain and psychosocial factors: a critical review of the literature

Poor pain assessment is cited as one barrier to the adequate treatment of cancer pain. The identification of relevant psychosocial factors may improve the assessment of chronic cancer pain. This article presents: 1) a critical review of the evidence for an association between chronic cancer pain and psychological distress, social support, and coping; 2) clinical implications of the findings; and 3) recommendations for future research. Fourteen of the 19 reviewed studies on psychological distress found a significant association between increased pain and increased distress. Seven of the eight studies on social support found significant association between higher levels of pain and decreased levels of social activities and social support. Three of the four studies that examined coping strategies found that increased catastrophizing was significantly associated with more intense pain. Based on several criteria, the evidence is considered Strong for psychological distress, Moderate for social support, and Inconclusive for coping. This review suggests that comprehensive chronic pain assessment should include routine screening for psychological distress.     

Profiling schoolchildren in pain and associated demographic and behavioural factors: a latent class approach

Musculoskeletal pain in adolescence is common and individuals frequently report pain in different sites. However, statistical analysis is often limited to considering one or a few pain sites. In this study latent class analysis was used to classify individuals into latent classes in terms of their patterns of endorsing ten musculoskeletal sites. Previously established covariates of musculoskeletal pain in adolescents were then assessed across emergent latent classes. The study was a cross sectional survey of adolescents attending post-primary schools in England. A total of 679 took part in the study with an age range from 11 to 14 years. Pain was operationalised as the occurrence of pain for one day or more in the past month. Schoolchildren self-reported on the incidence of pain aided by a nordic manikin. A three-class model emerged as the best fit. Classes were labelled 'Pain free' (63.4%), 'Neck and back' pain (28.2%) and 'Widespread' pain (8.4%). The 'Widespread' pain class was significantly related with Age (OR=1.79; 95%CI 1.24-2.57), Sex (OR=0.35, 95%CI 0.16-0.79), bag weight to body weight (OR=1.12, 95%CI 1.03-1.22), bag carrying method (OR=2.08, 95%CI 1.08-3.97), Schoolwork difficult (OR=2.78, 95%CI 1.27-6.07), and headaches (OR=2.13, 95%CI 1.65-2.76). While Strengths and Difficulties Questionnaire scores (OR=1.05, 95%CI 1.01-1.11), and Headaches (OR=1.78, 95%CI 1.39-2.26) were significant for the 'Back and neck' class. It is suggested that research should seek to identify typical pain profiles for adolescents, rather than concentrating on specific pain sites since some risk factors may be obscured or inflated by inappropriately amalgamating or segregating pain sites.     

Onset, prognosis and risk factors for widespread pain in schoolchildren: a prospective 4-year follow-up study

The standard rodent model of itch uses scratching with the hind limb as a behavioral response to pruritic stimuli applied to the nape of the neck. The assumption is that scratching is an indicator of the sensation of itch. But because only one type of site-directed behavior is available, one cannot be certain that scratching is not a response to nociceptive or other qualities of sensations in addition to, or instead of, itch. To extend the model, we administered chemical stimuli to the cheek of the mouse and counted scratching with the hind limb as an indicator of itch and wiping with the forelimb as an indicator of pain. An intradermal injection of histamine and capsaicin, known to evoke predominantly itch and pain, respectively, in humans, each elicited hind limb scratching behavior when injected into the nape of the neck of the mouse. In contrast, when the same chemicals were injected into the cheek of the mouse, there were two site-directed behaviors: histamine again elicited scratching with the hind limb, but capsaicin evoked wiping with the forelimb. We conclude that the "cheek model of itch" in the mouse provides a behavioral differentiation of chemicals that elicit predominantly itch in humans from those that evoke nociceptive sensations. That is, the model provides a behavioral differentiation between itch and pain in the mouse.     

Onset,prognosis and risk factors for widespread pain in schoolchildren: A prospective 4-year follow-up study

Little is known about the epidemiology of widespread pain (WSP) in children and adolescents. This study aims to estimate the new-onset and prognosis of WSP in schoolchildren and investigate factors predicting its development. A prospective study was conducted among 1756 schoolchildren (age 10–12 years) in Southern Finland. At baseline, information was collected on WSP, regional musculoskeletal pain symptoms, depressiveness, fatigue, sleep problems, physical activity and joint hypermobility. These children were contacted again 1 year and 4 years later to determine the outcome and the new-onset of WSP. A total of 1282 children (73%) of the baseline study population were found at both follow-ups. Of the children who had WSP at baseline, 31% and 30% reported persistence/recurrence of symptoms at 1- and 4-year follow-up, respectively. However, only 10% of these children reported WSP at both 1 and 4 years. Of the children who were free of WSP at baseline, 18% reported new-onset WSP at 1-year follow-up and 3% reported these symptoms at both follow-up times. The independent baseline risk factors of WSP were older age (OR 1.3 95% CI 1.0–1.8), female gender (OR 1.4, 1.1–1.9), depressiveness (OR 1.5, 1.1–2.2) and regional back pain symptoms (Neck pain: OR 1.7, 1.1–2.4; Upper back pain: OR 2.1, 1.1–4.1; Lower back pain: OR 3.0, 1.6–5.7). Both psychological factors and somatic pain symptoms predict future development of WSP in adolescents.