HIV and Headache: A Cross-Sectional Study.

INTRODUCTION: The head and neck are the second most common locations for pain among HIV-positive individuals. Most studies were conducted among HIV patients at an advanced stage of the disease. METHODS: This was a cross-sectional study. Patients with HIV and CD4+ T lymphocyte counts >500 were included. Semi-structured interview, the Headache Impact Test (HIT-6), and the Hospital Anxiety and Depression Scale were used. RESULTS: Of the 119 cases included, 63% were men. The mean age was 35.5 ± 10.4 years. Among the patients, 103 (87%) had headaches, 53 (45%) had migraines, 50 (42%) had tension-type headaches, and 53 (45%) had substantial and severe impact of headaches. Eleven patients had headaches that started after they had been diagnosed with HIV. These patients had more migraines (72% vs 43%; P < 0.05), greater intensity (8 ± 2 vs 6 ± 2; P < 0.01), and impact (HIT-6: 60 ± 11 vs 51 ± 12; P = 0.02) of headaches compared to others HIV patients. There were no correlations between CD4 counts and the intensity, frequency, or impact of headaches. CONCLUSIONS: HIV-positive patients had a high frequency of headaches, which had a great impact on patients' lives. The pattern most often found was migraine. There was no correlation between CD4 counts and the severity of headaches.

Migraine, Osmophobia, and Anxiety.

OBJECTIVES: To evaluate the association between osmophobia and the characteristics of patients and their headaches, among migraine patients. METHODS: This was a cross-sectional study. Patients who consecutively sought medical attendance in a primary care unit were asked about their headaches over the last 12 months. Those who had migraine were included. A semi-structured interview, the Headache Impact Test and the Hospital Anxiety and Depression Scale were used. RESULTS: 147 patients had migraine; 78 had osmophobia; 60 had significant anxiety symptoms; and 78 had significant depression symptoms. The mean age of these patients was 43.2 years (± 13.7); 91.2% were women. The mean length of time with complaints of headache was 13.8 years (± 12). Among the migraine patients, those with anxiety, more years of headache history, and phonophobia presented significantly more osmophobia (multivariate logistic regression). CONCLUSION: Osmophobia in migraine patients is associated with significant anxiety symptoms, length of headache history, and phonophobia.

Osmophobia and Headaches in Primary Care: Prevalence, Associated Factors, and Importance in Diagnosing Migraine.

OBJECTIVES: The aims of this study were to investigate the prevalence of osmophobia among primary headaches, evaluate the association between osmophobia and the characteristics of patients and their headaches, and assess the usefulness of this symptom for diagnosing migraine. METHODS: This was a cross-sectional study in a primary care unit. Patients who consecutively sought medical attendance in a primary care unit were asked about headaches (convenience sample). Those who reported having had at least 1 episode of headache during the last 12 months were interviewed. Semi-structured interview, the Headache Impact Test, and the Hospital Anxiety and Depression Scale were used. RESULTS: Two hundred thirty-five patients had headaches, 147 patients had migraine (53% of them had osmophobia), and 87 had tension-type headache (11.5% of them had osmophobia), and 1 patient had an unclassifiable headache. Among the headache patients, those with migraine and more years of headache history presented significantly more osmophobia (multivariate logistic regression).The sensitivity and specificity of osmophobia for establishing a diagnosis of migraine were 53.1% and 87.5%. The positive predictive value and negative predictive value were 87.6% and 52.7%. CONCLUSION: We found high prevalence of osmophobia among migraine patients, and this complaint is useful in making the diagnosis of migraine in primary care. Osmophobia is associated with migraine and more years of headache history.