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Open Access 01-12-2017 | Research article

The association of headache frequency with pain interference and the burden of disease is mediated by depression and sleep quality, but not anxiety, in chronic tension type headache

Authors: María Palacios-Ceña, Juan J. Fernández-Muñoz, Matteo Castaldo, Kelun Wang, Ángel Guerrero-Peral, Lars Arendt-Nielsen, César Fernández-de-las-Peñas

Published in: The Journal of Headache and Pain | Issue 1/2017

Abstract

Background

A better understanding of potential relationship between mood disorders, sleep quality, pain, and headache frequency may assist clinicians in determining optimal therapeutic programs. The aim of the current study was to analyze the effects of sleep quality, anxiety, depression on potential relationships between headache intensity, burden of headache, and headache frequency in chronic tension type headache (CTTH).

Methods

One hundred and ninety-three individuals with CTTH participated. Headache features were collected with a 4-weeks headache diary. The Hospital Anxiety and Depression Scale was used for assessing anxiety and depression. Headache Disability Inventory evaluated the burden of headache. Pain interference was determined with the bodily pain domain (SF-36 questionnaire). Sleep quality was assessed with Pittsburgh Sleep Quality Index. Path analyses with maximum likelihood estimations were conducted to determine the direct and indirect effects of depression, anxiety, and sleep quality on the frequency of headaches.

Result

Two paths were observed: the first with depression and the second with sleep quality as mediators. Direct effects were noted from sleep quality, emotional burden of disease and pain interference on depression, and from depression to headache frequency. The first path showed indirect effects of depression from emotional burden and from sleep quality to headache frequency (first model R ² = 0.12). Direct effects from the second path were from depression and pain interference on sleep quality and from sleep quality on headache frequency. Sleep quality indirectly mediated the effects of depression, emotional burden and pain interference on headache frequency (second model R ² = 0.18).

Conclusions

Depression and sleep quality, but not anxiety, mediated the relationship between headache frequency and the emotional burden of disease and pain interference in CTTH.

Ferrante T, Manzoni GC, Russo M, Camarda C, Taga A, Veronesi L et al (2013) Prevalence of tension-type headache in adult general population: the PACE study and review of the literature. Neurol Sci 34:S137–S138CrossRefPubMed

Dowson A (2015) The burden of headache: global and regional prevalence of headache and its impact. Int J Clin Pract Suppl 182:3–7CrossRef

Raggi A, Leonardi M (2015) Burden and cost of neurological diseases: a European North–south comparison. Acta Neurol Scand 132:16–22CrossRefPubMed

Global Burden of Disease Study (2013) Collaborators (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386:743–800

de Tommaso M, Fernández-de-las-Peñas C (2016) Tension type headache. Curr Rheumatol Rev 12:1–13

Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R (2006) Frequency of headache is related to sensitization: A population study. Pain 123:19–27CrossRefPubMed

Cathcart S, Petkov J, Winefield AH, Lushington K, Rolan P (2010) Central mechanisms of stress-induced headache. Cephalalgia 30:285–295CrossRefPubMed

de Tommaso M, Delussi M, Vecchio E, Sciruicchio V, Invitto S, Livrea P (2014) Sleep features and central sensitization symptoms in primary headache patients. J Headache Pain 15:64CrossRefPubMedPubMedCentral

Chiu YH, Silman AJ, Macfarlane GJ, Ray D, Gupta A, Dickens C, Morriss R, McBeth J (2005) Poor sleep and depression are independently associated with a reduced pain threshold. Results of a population based study. Pain 115:316–321CrossRefPubMed

10.

Beghi E, Bussone G, D'Amico D et al (2010) Headache, anxiety and depressive disorders: the HADAS study. J Headache Pain 11:141–150CrossRefPubMedPubMedCentral

11.

Uhlig BL, Engstrøm M, Ødegård SS, Hagen KK, Sand T (2014) Headache and insomnia in population-based epidemiological studies. Cephalalgia 34:745–751CrossRefPubMed

12.

Zwart JA, Dyb G, Hagen K, Ødegård KJ, Dahl AA, Bovim G et al (2003) Depression and anxiety disorder associated with headache frequency: The Nord-Trøndelag Health Study. Eur J Neurol 10:147–152CrossRefPubMed

13.

Rains JC, Davis RE, Smitherman TA (2015) Tension-type headache and sleep. Curr Neurol Neurosci Rep 15:520CrossRefPubMed

14.

Sancisi E, Cevoli S, Vignatelli L, Nicodemo M, Pierangeli G, Zanigni S, Grimaldi D, Cortelli P, Montagna P (2010) Increased prevalence of sleep disorders in chronic headache: a case–control study. Headache 50:1464–1472CrossRefPubMed

15.

Serafini G, Pompili M, Innamorati M, Gentile G, Borro M, Lamis DA, Lala N, Negro A, Simmaco M, Girardi P, Martelletti P (2012) Gene variants with suicidal risk in a sample of subjects with chronic migraine and affective temperamental dysregulation. Eur Rev Med Pharmacol Sci 16:1389–1398PubMed

16.

Naughton F, Ashworth P, Skevington SM (2007) Does sleep quality predict pain-related disability in chronic pain patients? The mediating roles of depression and pain severity. Pain 127:243–252CrossRefPubMed

17.

Baldwin CM, Ervin AM, Mays MZ, Robbins J, Shafazand S, Walsleben J et al (2010) (2010) Sleep disturbances, quality of life, and ethnicity: the Sleep Heart Health Study. J Clin Sleep Med 6:176–183PubMedPubMedCentral

18.

ICHD-III (2013) International classification of headache disorder: Headache Classification Subcommittee of the International Headache Society, 3nd edition. Cephalalgia 33:629–808CrossRef

19.

Phillip D, Lyngberg AC, Jensen R (2007) Assessment of headache diagnosis: a comparative population study of a clinical interview with a diagnostic headache diary. Cephalalgia 27:1–8CrossRefPubMed

20.

Jensen R, Tassorelli C, Rossi P, Allena M, Osipova V, Steiner T, Sandrini G, Olesen J, Nappi G, Basic Diagnostic Headache Diary Study Group (2011) A basic diagnostic headache headache diary (BDHD) is well accepted and useful in the diagnosis of headache. a multicentre European and Latin American study. Cephalalgia 31:1549–1560CrossRefPubMed

21.

Jensen MP, Turner JA, Romano JM, Fisher L (1999) Comparative reliability and validity of chronic pain intensity measures. Pain 83:157–162CrossRefPubMed

22.

Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370CrossRefPubMed

23.

Herrmann-Lingen C, Buss U, Snaith RP (2011) Hospital Anxiety and Depression Scale – Deutsche version (HADS-D). Verlag Hans Huber, Bern

24.

Juang KD, Wang SJ, Lin CH, Fuh JL (1999) Use of the Hospital Anxiety and Depression Scale as a screening tool for patients with headache. Zhonghua Yi Xue Za Zhi (Taipei) 62:749–755

25.

Cole JC, Dubois D, Kosinski M (2007) Use of patient-reported sleep measures in clinical trials of pain treatment: a literature review and synthesis of current sleep measures and a conceptual model of sleep disturbance in pain. Clin Ther 29:2580–2588CrossRefPubMed

26.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213CrossRefPubMed

27.

Carpenter JS, Andrykowski MA (1998) Psychometric evaluation of the Pittsburgh sleep quality index. J Psychosom Res 45:5–13CrossRefPubMed

28.

Jacobson GP, Ramadan NM, Norris L, Newman CW (1994) The Henry Ford hospital headache disability inventory. Neurology 44:837–842CrossRefPubMed

29.

Jacobson GP, Ramadan NM, Norris L, Newman CW (1995) Headache disability inventory (HDI): short-term test-retest reliability and spouse perceptions. Headache 35:534–539CrossRefPubMed

30.

Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483CrossRefPubMed

31.

McHorney CA, Ware JE, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263CrossRefPubMed

32.

Abuckle JL, Wothke W (1999) Amos 4.0 users guide. Small waters, Chicago

33.

Duncan O (1966) Path analysis: sociological examples. Am J Sociology 72:1–12CrossRef

34.

Jöreskog KG, Sörbom D (1979) Advanced in factor analysis and structural equation models. M.A. Abl, Cambridge

35.

Saris WE, Stronkhorst H (1984) Casual modelling in non-experimental research: an introduction to the LISREL approach. Sociometric Research Foundation, Amsterdam

36.

Hu L, Bentler PM (1999) Cut-off criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Mod 6:1–55CrossRef

37.

Bentler PM (1990) Comparative fit indices in structural models. Psychological Bull 107:238–246CrossRef

38.

Steiger JH, Lind C (1980) Statistically based tests for the number of common factors, Paper presented at the annual meeting of the Psychometric Society, Iowa City, IA

39.

Houle TT, Butschek RA, Turner DP, Smitherman TA, Rains JC, Penzien DB (2012) Stress and sleep duration predict headache severity in chronic headache sufferers. Pain 153:2432–2440CrossRefPubMedPubMedCentral

40.

Zebenholzer K, Lechner A, Broessner G, Lampl C, Luthringshausen G, Wuschitz A, Obmann SM, Berek K, Wöber C (2016) Impact of depression and anxiety on burden and management of episodic and chronic headaches - a cross-sectional multicentre study in eight Austrian headache centres. J Headache Pain 17:15CrossRefPubMedPubMedCentral

41.

Terry EL, DelVentura JL, Bartley EJ, Vincent AL, Rhudy JL (2013) Emotional modulation of pain and spinal nociception in persons with major depressive disorder (MDD). Pain 154:2759–2768CrossRefPubMed

42.

Wang J, Huang Q, Li N, Tan G, Chen L, Zhou J (2013) Triggers of migraine and tension-type headache in China: a clinic-based survey. Eur J Neurol 20:689–696CrossRefPubMed

43.

Haque B, Rahman KM, Hoque A, Hasan AT, Chowdhury RN, Khan SU, Alam MB, Habib M, Mohammad QD (2012) Precipitating and relieving factors of migraine versus tension type headache. BMC Neurol 12:82CrossRefPubMedPubMedCentral

44.

Rains JC (2008) Chronic headache and potentially modifiable risk factors: screening and behavioral management of sleep disorders. Headache 48:32–39CrossRefPubMed

45.

Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D (2014) The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. Int J Epidemiol 43:476–493CrossRefPubMedPubMedCentral

Title: The association of headache frequency with pain interference and the burden of disease is mediated by depression and sleep quality, but not anxiety, in chronic tension type headache
Authors: María Palacios-Ceña
Juan J. Fernández-Muñoz
Matteo Castaldo
Kelun Wang
Ángel Guerrero-Peral
Lars Arendt-Nielsen
César Fernández-de-las-Peñas
Publication date: 01-12-2017
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2017
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-017-0730-5

At a glance: The STEP trials

Springer Medicine

The association of headache frequency with pain interference and the burden of disease is mediated by depression and sleep quality, but not anxiety, in chronic tension type headache

Abstract

Background

Methods

Result

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Result

Conclusions

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