ABSTRACT
BACKGROUND: Migraine without aura causes acute and chronic pain and partially compromises patients' social functioning and work performance. Over the past years, psychiatric comorbidities were frequently observed in these patients, together with coping difficulties and typical personality traits. The aim of this study was to identify whether migraine patients and controls share distinctive personality traits. METHODS: 105 consecutive patients suffering from migraine without aura referred to the Headache Center of Turin University were enrolled in the study and compared to a control group of 79 healthy subjects. Patients and controls completed several psychometric questionnaires, including the Temperament and Character Inventory, the Beck Depression Inventory and the State-Trait Anger Expression Inventory. RESULTS: Patients suffering from migraine show more depressive symptoms, difficult anger management with a tendency to hypercontrol, and a distinctive personality profile with high harm avoidance, high persistence and low self-directedness. When a logistic regression was performed, the only significant predictors of migraine were temperament variables. CONCLUSIONS: The results suggest that the personality traits and psychosomatic mechanisms of migraine patients may make them vulnerable to stress and less skilled in coping with pain. These traits correlate with dysregulated neurotransmitter systems which may also be part of the psychobiological components of personality, depressive disorders and migraine itself.
Subject(s)
Anger , Character , Depression/psychology , Migraine without Aura/psychology , Somatoform Disorders/psychology , Temperament , Adaptation, Psychological , Adult , Avoidance Learning , Female , Humans , Internal-External Control , Male , Middle Aged , Personality Inventory , Reference Values , Risk Factors , Self Efficacy , Stress, Psychological/complications , Surveys and QuestionnairesABSTRACT
We examined the distribution of HLA-DRB1 alleles in a cohort of 255 Italian migraine patients and in a control group of 325 healthy subjects. The frequency of DRB1*12 allele was found to be significantly reduced (p=0.02) in patients with migraine while the DRB1*16 allele was significantly increased (p=0.04) in comparison with controls. When the patients were divided into disease subgroups (migraine with and without aura), HLA-DRB1**16 allele was significantly increased (p<0.05) only in migraine without aura patients. We conclude that, in Italian patients, migraine is associated with different alleles of the HLA-DRB1 locus. Our data suggest the presence of a genetic susceptibility factor for migraine within the HLA region.
Subject(s)
HLA-DR Antigens/genetics , Migraine with Aura/genetics , Migraine without Aura/genetics , Polymorphism, Genetic , Adult , Female , Genetic Predisposition to Disease , HLA-DRB1 Chains , Humans , Italy , Male , Middle AgedABSTRACT
The objective was to evaluate the prevalence and the characteristics of anger and emotional distress in migraine and tension- type headache patients. Two hundred and one headache patients attending the Headache Center of the University of Turin were selected for the study and divided into 5 groups: (1) migraine, (2) episodic tension-type headache, (3) chronic tension-type headache, (4) migraine associated with episodic tension-type headache and (5) migraine associated with chronic tension-type headache. A group of 45 healthy subjects served as controls. All the subjects completed the State-Trait Anger Expression Inventory, the Beck's Depression Inventory and the Cognitive Behavioral Assessment. Anger control was significantly lower in all headache patients (p<0.05) except in migraineurs. Patients with migraine and tension-type headache showed a significantly higher level of angry temperament and angry reaction (p<0.05). In addition, chronic tension-type headache and migraine associated with tension-type headache patients reported a higher level of anxiety (p<0.05), depression (p<0.001), phobias (p<0.001) and obsessive-compulsive symptoms (p<0.01), emotional liability (p<0.001) and psychophysiological disorders (p<0.001). Our study shows that chronic tension-type headache and migraine associated with tension-type headache patients present a significant impairment of anger control and suggests a connection between anger and the duration of headache experience.
Subject(s)
Anger , Migraine Disorders/psychology , Mood Disorders/epidemiology , Mood Disorders/psychology , Tension-Type Headache/psychology , Adult , Chronic Disease/epidemiology , Chronic Disease/psychology , Comorbidity , Cross-Sectional Studies , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Female , Headache Disorders/psychology , Humans , Male , Middle Aged , Neuropsychological Tests , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/psychology , Phobic Disorders/epidemiology , Phobic Disorders/psychology , PrevalenceABSTRACT
OBJECTIVE: To evaluate whether polymorphisms of the HFE gene would modify the occurrence and the clinical features of cluster headache (CH). BACKGROUND: Recent studies suggested that iron metabolism may be involved in the pathophysiology of primary headaches. The HFE gene encodes for a protein that modulates iron absorption. Mutations in this gene are responsible for toxic iron overload in several body organs. METHODS: Genomic DNA was extracted from 109 CH patients and 211 age and sex-matched healthy controls and genotyped for the C282Y and H63D mutations of the HFE gene. Allele and genotype frequencies of the HFE gene were compared between cases and controls. The clinical characteristics of the disease were compared according to the different HFE gene genotypes. RESULTS: No C282Y mutation was found in both cases and controls. The prevalence of the H63D mutation was nearly identical in cases and controls. The four patients carrying the HFE D63D genotype showed a significantly (P < .001) later age at onset of the disease in comparison with both H63H and H63D patients. The remaining clinical characteristics of the disease did not significantly differ in the presence or absence of the H63D mutation. CONCLUSION: Our data do not support the hypothesis that genetic variations within the HFE gene are associated with CH. However, the HFE gene may influence the disease phenotype and may be regarded as a disease modifier gene.
Subject(s)
Cluster Headache/genetics , Histocompatibility Antigens Class I/genetics , Membrane Proteins/genetics , Mutation , Adult , Cohort Studies , Female , Gene Frequency , Hemochromatosis Protein , Humans , Male , Middle Aged , Polymorphism, GeneticABSTRACT
We compared the clinical, psychological and pharmacological characteristics of patients with familial migraine and patients with sporadic migraine. Five hundred and thirty consecutive new patients attending our Headache Center over a two-year period were involved in the study. The patients were divided into two groups: A. Familial migraine (famM)--at least one first-degree relative affected; B. Sporadic migraine (spoM)--no first-degree relative affected. Four hundred and twenty-four patients (80%) fulfilled the criteria for famM and 106 (20%) for spoM. The patients with famM showed a significantly (p<0.01) earlier age at onset of the disease. No significant difference in all the remaining features examined was found. Our data suggest that famM and spoM represent a single disease entity.
