|
|
||||
|
Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
||||
|
ISSN 1681-715X |
||||
|
||||
|
- |
||||
|
Short Communication |
||||
|
- |
||||
|
Volume 22 |
October - December 2006 |
Number 4 |
||
|
|
||||
|
|
||||
|
|
||||
|
Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
||||
|
ISSN 1681-715X |
||||
|
||||
|
- |
||||
|
Short Communication |
||||
|
- |
||||
|
Volume 22 |
October - December 2006 |
Number 4 |
||
|
|
||||
|
|
||||
Personality Characteristics in
Patients with Migraine HeadachesAli A. Rezaei1, Farshid Shamsaei2, Nima Rezaei3
ABSTRACT
Objective: To determine the personality characteristics in patients with migraine headaches.
Method: The sample group of this cross-sectional study included 96 adult patients suffering from migraine who were randomly selected to be tested by Minnesota Multiphasic Personality Inventory (MMPI), from which eight personality scales (hypochondriasis, depression, schizophrenia, psychopathy, paranoia, psychasthenia, hysteria and mania) were reviewed.
Results: Of all participants, 77 were female, 66 were married, 58 had a college degree or higher education and the patients’ mean age was 32.8 years. As of personality characteristics, the symptoms of somatization, hysteria and obsessive-compulsive disorder were more prominent in women, whereas depression, anxiety and psychasthenia were the main features of MMPI test interpretation among men.
Conclusion: Patients with migraine headaches have specific personality features that may affect the initiation and exacerbation of headaches and the symptoms of migraine disease.Considering the personality and psychologic aspects of these patients could be beneficial in their management.
KEY WORDS: Migraine, Personality, Headache.
Pak J Med Sci October - December 2006 Vol. 22 No. 4 480-482
1. Dr. Ali A. Rezaei,
Department of Neurology, Sina Hospital.2. Dr. Farshid Shamsaei,
Faculty of Nursing,3. Dr. Nima Rezaei
Medical Student,1-3: Hamedan University of Medical Science,
Postal Code: 65178
Hamedan, IRAN.Correspondences:
Dr. Farshid Shamsaei,
E-Mail: shamsaei68@yahoo.com* Received for Publication: December 9, 2005
* Accepted: April 30, 2006
INTRODUCTION
Migraine is a common familial disorder characterized by episodic throbbing headaches which are typically unilateral. It usually begins in childhood, adolescence and early adulthood and the prevalence decreases with increasing age. The prevalence rate among the Caucasians has been reported to be 4-6% in men and 13-18% in women; however, the rate is lower among Asians.
1There are temporal and individual differences in the recurrence rate of migraine attacks which can be attributed to environmental and intrinsic factors such as hormones and especially emotional stress.
2Several studies have been performed to investigate the effects of biologic, environmental, social and psychologic factors on the initiation and exacerbation of migraine attacks. The results of these studies have demonstrated the relationship between patients’ psychologic and personality factors and their migraine headaches. For example, Breslau et al’s report on the relation of headache and depression in adults revealed that there is a significant relationship between migraine headaches and depressive disorders.
3 According to Kaplan and Sadock two thirds of migraine patients have a positive family history; they have obsessive, suppressive and aggressive personalities and will develop headaches following emotional stress.4 Polly et al studied the effects of psychologic and social factors on headache among high school students. The results obtained from 652 students (303 boys and 349 girls) showed a significant association between headache and depression, somatization and anxiety.5Kurakurum et al compared 35 patients suffering from chronic migraine and 50 acutely affected patients for indices of depression, hysteria, hypochondriasis and psychasthenia; the results indicated that these scales are all significantly higher in chronic migraine group.
6 Migraine has a direct association with anxiety and stress, and psychologic factors have a clear effect on the progression and prolongation of migraine headaches.7-9PATIENTS AND METHODS
In this cross-sectional study, the study population was patients with migraine headaches attending the outpatient clinic of neurology in Sina Hospital, Hamadan, Iran. Patients presented with a chief complaint of headache and were diagnosed, after examination by a neurologist, with migraine according to the New International Headache Society Definition of Migraine,
14 were randomly selected.Data gathering tool was Minnesota Multiphasic Personality Inventory (MMPI). We used a concise form of MMPI questionnaire which has been modified according to the characteristics of the Iranian population. The patients were assessed in eight personality scales including hypochondriasis (Hs), hysteria (Hy), depression (D), schizophrenia (Sc), psychopathy (Pd), paranoia (Pa), psychasthenia (Pt) and mania (Ma). Descriptive statistical tests including mean and standard deviation were used to analyze the data and MMPI test results have been interpreted according to the profiles.
RESULTS
Of the total 96 patients studied, 77 (80.22%) were female and 19 (19.78%) were male. Their average age was 32.8 years; 66 (68.75%) were married and 58 (45.83%) had a college degree. Calculating the standard deviations of eight personality scales and interpreting MMPI test profiles, the examinees’ personality characteristics were determined as follows:
A. Women suffering from migraine headaches have characteristic features of somatoform disorder, conversion disorder and tension disorder. They do not have profound and acceptable social relations. Pain is always a complaint, and they have hysteric features, guilty feeling and depression. Obsessive thinking and compulsive actions are common (Table-I).
B. Men with migraine headaches report anxiety, psychasthenia and depressive symptoms. They typically look nervous, tense, sensitive and agitated (Table-II).
DISCUSSION
Regarding the personality characteristics of migraine patients the results of this study showed that the signs and symptoms of hysteria, somatization, depression and anxiety were more prominent. Psychasthenia, inappropriate social relations, sensitiveness and nervousness were other features seen in these patients.
MMPI test interpretation reveals that women suffering from migraine headaches report hysteric features and obsessive-compulsive behavior, whereas anxiety, depression and psychasthenia were more pronounced among men. Several studies have been performed on the relation between migraine and the patients’ psychologic and personality characteristics. Breslau et al reported that major depression disorder increases the risk of migraine headaches and migraine headaches is associated with higher risk of major depression.
9According to Huber contradictory reports have been presented on the relation of migraine and personality during the past 50 years, and a review of literature confirms that stress can be a trigger for initiation and repetition of migraine attacks.
10 Mangini et al studied 56 women with migraine headaches in a longitudinal study using MMPI test. Their results revealed a significant relation between depression and migraine.11 Karakurum et al (2004) investigated the personality characteristics, depression and anxiety features as possible risk factors for chronic migraine in 35 patients with chronic and 50 with acute migraine. The results regarding scales of depression, psychasthenia, hypochondriasis and hysteria showed that these scales were all significantly higher in the chronic group than in the acute migraine patients.6Pelley et al evaluated headache- related psychologic-social factors among high school students and reported that the signs and symptoms of depression, anxiety and somatization were more pronounced among those suffering from headache than those with no such complaints.
5 Okasha et al reported somatoform disorders in 43% of patients with non-organic headaches and 20% of individuals with organic headaches. Also, 77% of patients suffering from non-organic headaches have personality disorders, while this figure was 24% among those with organic headache.12 In a study of 80 male and female patients divided into acute and chronic migraine groups, Galego et al reported that depressive features were higher in both groups compared with controls.13 According to Kaplan and Sadock two thirds of migraine patients have obsessive personality, are over-controlled and idealist, and develop migraine attacks following an emotional conflict or stress.4 Findings of the present study confirm the association between migraine and psychologic and personality features reported by other studies. The results showed that patients with migraine headache have specific personality characteristics that may be effective in initiation and exacerbation of migraine attacks. It could also be suggested that there is a reciprocal relation between personality and migraine disease; however, this needs further investigation. In other words, it should be considered whether personality characteristics precipitate migraine attacks or migraine leads to specific personality features. The interaction between psychologic personality factors and somatic features should therefore be considered in treating migraine patients and there should be cooperation between neurologists and psychiatrists in any therapeutic effort.REFERENCE
1. Victor M, Ropper AH. Principles of Neurology. Seventh Editions 2001.
2. Waldie KE, Pocelton R. Physical and psychological correlate of primary headache in young adulthood. Neurosurg Psych 2003; 72: 86-92.
3. Breslau, N. Head ache and Major depression. Neuroloyy 2000; 45: 308-12.
4. Kaplan. Sadock. Comprehensive textbook of psychiatry. Seventh Edition 2000.
5. Pelley psychosocial factors associated with headache in Junior high school student J Ped Psychol 1999.vol: 24;no: 1: 13-23.
6. Karakurum, B. Personality, depression and anxiety as risk factors for chronic Migraine. Int J Neurosci 2004; 114(11): 1391-9.
7. Ulrichv, Olsen J, Gerril M, Russel MB. Possible risk factors and precipitins for Migraine with aura in discordant twin-pairs. Cephalalgia 2000; 20:821-2.
8. Waldieke U. Child hood, stress in adolescence and primary headache in young adulthood. Headache 2001; 41:1-10
9. Breslau N. "Comorbidity of Migraine and depression" Needy 2003; 60: 1308-12.
10. Huber D, Henrich G. Personality traits and stress sensitivity in Behave Med 2003; 29(1): 4-13.
11. Mahgini F. Migraine in women Personality traits. Depression cephalalgia 2003; 23(3): 186-92.
12. Okasha A. A psychiatric study of Nonorganic chronic headache patients. Psychosomaties 1999; 40:233-8.
13. Galego JCB "Depression and Migraine" Art Neuropsi Quiatr 2004; 62(3-B)
14. Saper JR X. Headache management. Lippincott Co 1999; 9.
HOME | SEARCH | CURRENT ISSUE | PAST ISSUES
Professional
Medical Publications
Room No. 522, 5th Floor, Panorama Centre
Building No. 2, P.O. Box 8766, Saddar, Karachi - Pakistan.
Phones : 5688791, 5689285 Fax : 5689860
pjms@pjms.com.pk
