Temperament and character profiles of patients with tension-type headache and migraine.

The aim of this present study was to evaluate the temperament and character profiles of persons with tension-type headache (TTH) and migraine, and to compare the results with those of healthy controls. The study population consisted of 81 patients with TTH (60 female, 21 male) and 56 patients with migraine (34 female, 17 male) aged 18-50 years, according to the criteria of the International Headache Society with age and gender - matched healthy control subjects (54 female, 28 male). All participants were instructed to complete a self-administered 240-item temperament and character inventory (TCI) questionnaire and Beck Depression Inventory (BDI). The TCI assesses four dimensions of temperament, namely, novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P), and three dimensions of character, being self-directedness (SD), cooperativeness (C) and self-transcendence (ST). According to the TCI biosocial model, the temperament dimension HA is suggested to indicate central serotonergic turnover, which is further correlated with depressive state. It was found that mean BDI scores were significantly higher in patients with TTH and migraine than in those of the controls. The BDI scores were positively correlated with HA scores (r = 0.295, P < 0.001) and negatively correlated with SD (r = -0.386, P < 0.001) and C scores (r = -0.164, P= 0.016). Multivariate analysis showed that BDI scores had significant covariation for HA, SD and C. Despite using the BDI score as a covariate, TTH patients had higher HA scores (P = 0.01) than did the control subjects. No significant differences were found between the groups regarding main NS, RD, P, SD, C and ST scores. Based on the main results of this study, it is suggested that higher serotonergic activity related to HA scores in TTH patients and their relationship with depressive symptomatology supports the role of central serotonergic involvement in TTH.

[Temperament and character profile of patients with chronic tension-type headache]. / Kronik Gerilim Tipi Bas Agrili Hastalarda Mizaç ve Karakter Profili.

OBJECTIVE: To examine the personality profiles of patients with chronic tension-type headache (CTTH) and controls using the Temperament and Character Inventory (TCI), and to determine whether the data acquired were related to the depressive status of patients. METHOD: Forty-eight patients with CTTH and 50 age, gender and education level matched, healthy, headache-free control subjects were selected for the study. The Turkish versions of TCI and Beck Depression Inventory (BDI) were applied to all participants. In the TCI, novelty seeking (NS), harm avoidance (HA), reward dependence (RD) and persistence (P) are the 4 dimensions of temperament; self-directedness (SD), cooperativeness (C) and self-transcendence (ST) are 3 dimensions of character. RESULTS: The BDI scores were positively correlated with HA scores (r=0.486, p<0.001) and negatively correlated with SD (r=-0.412, p<0.001) and C scores (r=-0.212, p=0.016). Higher HA scores and lower SD scores were found in CTTH patients when compared to the controls. After using the adjusted TCI scores (after being partialled out for the effect of BDI scores), while similar results of higher HA scores relative to healthy controls were found, SD scores did not differ statistically between the two groups. NS, RD, P, C and ST scores did not differ significantly between the two groups, using either adjusted or unadjusted TCI scores. CONCLUSION: The study of personality suggests strong effect of depressive status on SD scores in CTTH patients. Higher HA scores in CTTH patients support the role of serotonergic involvement in the pathophysiology of CTTH.