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Quality of life in chronic daily headache

A study in a general population

From the Service of Neurology (Drs. Pascual and Guitera), University Hospital Marqués de Valdecilla, Santander; and Health Center of Camargo (Dr. Castillo) and Primary Care Management (Dr. Muñoz), Cantabria, Spain.

Address correspondence and reprint requests to Dr. Julio Pascual, Service of Neurology, University Hospital Marqués de Valdecilla, 39008 Santander, Spain; e-mail: pascualj{at}unican.es

Objective: To analyze the quality of life (QoL) of subjects with chronic daily headache (CDH) in the general population.

Methods: QoL was studied, using the generic instrument Short Form-36 (SF-36), in 89 unselected subjects from an epidemiologic study in the general population who fulfilled CDH criteria. SF-36 scores were adjusted for comorbid conditions. A total of 89 healthy matched subjects were recruited as a control group. An additional matched group of 89 otherwise healthy subjects with episodic migraine was recruited as controls only to those with transformed migraine (TM).

Results: CDH subjects showed a significant decrease in each health-related concept of the SF-36 as compared with healthy subjects. The highest decreases were seen for role physical, bodily pain, vitality, and social functioning. There was no significant difference in SF-36 scores in subjects with chronic tension-type headache as compared with TM subjects. TM individuals showed lower values in each health-related concept when compared with patients with episodic migraine, these decreases being significant for general health, vitality, and mental health. Finally, CDH subjects without analgesic overuse showed higher values in each concept of the SF-36 than those with analgesic overuse. Despite the low proportion of abusers in this study, differences were significant for physical functioning and bodily pain.

Conclusions: In the general population, CDH reduced all QoL aspects studied with the SF-36. This reduction in QoL was most marked in subjects with analgesic overuse. QoL was affected more by the chronicity than by the intensity of pain.

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