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Zhang Y, Huang W, Pan S, Shan Z, Zhou Y, Gan Q, Xiao Z. New management strategies for primary headache disorders: Insights from P4 medicine. Heliyon 2023; 9:e22285. [PMID: 38053857 PMCID: PMC10694333 DOI: 10.1016/j.heliyon.2023.e22285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/21/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
Primary headache disorder is the main cause of headache attacks, leading to significant disability and impaired quality of life. This disorder is increasingly recognized as a heterogeneous condition with a complex network of genetic, environmental, and lifestyle factors. However, the timely diagnosis and effective treatment of these headaches remain challenging. Precision medicine is a potential strategy based on P4 (predictive, preventive, personalized, and participatory) medicine that may bring new insights for headache care. Recent machine learning advances and widely available molecular biology and imaging data have increased the usefulness of this medical strategy. Precision medicine emphasizes classifying headaches according to their risk factors, clinical presentation, and therapy responsiveness to provide individualized headache management. Furthermore, early preventive strategies, mainly utilizing predictive tools, are critical in reducing headache attacks and improving the quality of life of individuals with headaches. The current review comprehensively discusses the potential application value of P4 medicine in headache management.
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Affiliation(s)
| | | | - Songqing Pan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zhengming Shan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Yanjie Zhou
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Quan Gan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zheman Xiao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
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Migraine and Neuroticism: A Scoping Review. Behav Sci (Basel) 2022; 12:bs12020030. [PMID: 35200282 PMCID: PMC8869701 DOI: 10.3390/bs12020030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 02/07/2023] Open
Abstract
Headache is the first cause of consultation in neurology, and one of the most frequent reasons for consultation in general medicine. Migraine is one of the most common, prevalent, and socioeconomically impactful disabling primary headache disorders. Neuroticism can be conceptualized as a disposition to suffer anxiety and emotional disorders in general. Neuroticism has been associated with various mental and physical disorders (e.g., chronic pain, depression), including migraine. With the aim to explore in depth the relationship between migraine and neuroticism, and contribute to the understanding of this relation in order to provide a better treatment for migraine patients based on a personalized and more comprehensive approach, a scoping review was performed using PubMed, Scopus, and Web of Science. Databases were searched independently by the two researchers, reaching a final set of 18 articles to be included. The search terms were: migraine and neuroticism. Neuroticism seems to be highly prevalent in migraine patients. Findings reveal that migraine patients with comorbid depression and anxiety showed higher levels of neuroticism. Depression has been associated with an increased risk of transformation from episodic to chronic migraine whereas neuroticism might be a mediator factor. Neuroticism also might be a mediator factor between childhood maltreatment and migraine. The revision conducted confirms that: (1) Migraine patients usually have a higher level of neuroticism and vulnerability to negative affect, compared to non-migraineurs and tension-type headache patients. (2) Neuroticism is associated with migraine. Nonetheless, more research is needed to clarify potential moderators of this relationship and the role of neuroticism itself in this disease. This knowledge might be useful in order to promote a better management of negative emotions as part of intervention programs in migraine.
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Sair A, Sair YB, Akyol A, Sevincok L. Affective temperaments and lifetime major depression in female migraine patients. Women Health 2020; 60:1218-1228. [DOI: 10.1080/03630242.2020.1815930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ahmet Sair
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Yasan Bilge Sair
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Ali Akyol
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Levent Sevincok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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Personality profile and depression in migraine: a meta-analysis. Neurol Sci 2019; 41:543-554. [PMID: 31832997 DOI: 10.1007/s10072-019-04174-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 11/22/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite the clinical importance of psychological factors in migraine, the relationship between personality traits, depression, and migraine has been poorly investigated. OBJECTIVE To delineate the personality profile distinctive for migraineurs and to explore the relationship between personality traits and depression in migraineurs compared to non-migraineurs. METHODS A systematic literature search was performed up to March 2019 using PsycInfo (PROQUEST), PubMed and Scopus. Sixteen primary studies met inclusion and exclusion criteria and were included in the meta-analysis. RESULTS The meta-analysis on the personality defined according to Psychobiological model revealed high Harm Avoidance (Hedges'g = 0.31; 95% confidence interval [CI] = 0.01-0.60), Persistence (Hedges'g = 0.37; 95% CI = 0.01to - 0.72) and low self-directedness (Hedges'g = - 0.33; 95% CI = -0.57 to - 0.09) in migraineurs. The meta-analysis on the personality defined according to Three Factor Model revealed high neuroticism (Hedges'g = 0.47; 95% CI = 0.32-0.63) and low extraversion (Hedges'g = - 0.08; 95% CI = - 0.14 to - 0.03) in migraineurs. Meta-regression analysis revealed that neuroticism moderated the relationship between depression and migraine. CONCLUSION The findings evidenced that migraine is characterized by specific personality traits. Among them, neuroticism influenced the severity of depression in migraineurs, and, therefore, an early evaluation of the personality traits could allow identifying patients susceptible to develop migraine-associated psychopathological symptoms.
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Petraşcu CM, Vaşadi VM, Moisă R, Manea MM. The link between personality dimensions and pain perception in patients with diabetes mellitus or cancer. Med Pharm Rep 2019; 92:253-260. [PMID: 31460506 PMCID: PMC6709967 DOI: 10.15386/mpr-1300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/02/2019] [Accepted: 04/13/2019] [Indexed: 11/26/2022] Open
Abstract
Background and aims Diabetes mellitus and cancer are two diseases with a strong psychological impact. Personality traits modulate the perception of pain and the response to disease. The specificity of this study consists of the assessment of personality, pain and emotional impact in the two diseases. Method The study included 130 participants assigned to 3 groups: patients with diabetes mellitus, patients with cancer disease, and a control group. The personality traits of all the participants were analyzed using Cloninger’s Temperament and Character Inventory (TCI). For the evaluation of pain, as well as associated anxiety and depression in the diabetes and cancer groups, the Brief Pain Inventory (BPI) and the Hospital Anxiety and Depression Scale (HADS) were used. Results Patients with diabetes mellitus and cancer disease had significantly higher total values on the Harm Avoidance scale (HA) (p<0.001) and lower total values on the Self-Directedness scale (SD), Reward Dependence scale (RD), Cooperativeness scale (CO) (p<0.001) compared to the control group. Major anxiety was predominant in patients with diabetes mellitus (34%), and major depression was prevalent in cancer patients (17.5%). Patients with diabetes mellitus obtained a significantly higher severity score at BPI scale than patients with cancer disease (p=0.03). Conclusions The existence of a mutual personality profile featuring high levels of Harm Avoidance and low levels of Self-Directedness in patients with diabetes mellitus and cancer who experience pain has great implications for the therapeutic approach. A potential future avenue of management in these diseases may lie in targeting particular personality aspects of chronic pain patients.
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Affiliation(s)
| | | | - Răzvan Moisă
- Psychiatry Clinic III, Emergency County Hospital Cluj, Cluj-Napoca, Romania
| | - Marinela Minodora Manea
- Discipline of Medical Psychology, Department of Medical Education, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Correlation of affective temperament and psychiatric symptoms in palliative care cancer patients. Wien Klin Wochenschr 2018; 130:653-658. [PMID: 30350187 PMCID: PMC6244865 DOI: 10.1007/s00508-018-1400-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022]
Abstract
Background Psychiatric symptoms are common in terminally ill patients. Studies linking temperamental traits and psychiatric disorders in patients suffering from advanced disease are rare. This study investigated the influence of temperament on depression and anxiety in palliative care cancer patients. Methods A total of 53 patients at the palliative care unit (PCU) of the Medical University of Vienna were enrolled in the study. Patients filled out the TEMPS-M and the brief PHQ-9 questionnaires to examine associations between temperament, psychiatric symptoms and sociodemographic parameters. Results Pain (67%), anorexia (58%), constipation (42%) and nausea/vomiting (40%) were the most prevalent self-reported symptoms. Self-reported symptoms of depression were less commonly reported (21.8%) than unveiled by the structured assessment by the PHQ-9 questionnaire: 26.4% (n = 14) showed mild symptoms of depression and 64.1% (n = 34) had a major depressive disorder (MDD) according to PHQ-9. The depressive and cyclothymic temperaments showed significant associations with depressive (both: p < 0.001) as well as symptoms of anxiety (p = 0.002; p = 0.036). Furthermore, the anxious temperament was significantly associated with symptoms of depression (p = 0.027). Conclusions Mood disorders are common in palliative care patients, as the majority of the patients were suffering from MDD. The depressive, cyclothymic and anxious temperaments were found to be correlated with depressive and anxious symptoms. A sensitization in this field might bring further improvements for the quality of life of palliative care patients and help to appropriately address psychiatric symptoms in palliative care.
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Vulnerability to Psychopathology and Dimensions of Personality in Patients With Fibromyalgia. Clin J Pain 2017; 33:991-997. [PMID: 28448425 DOI: 10.1097/ajp.0000000000000506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Fibromyalgia (FM) patients may present psychopathology and some characteristic personality traits that may affect their adaptation to the disease. The aim of this paper was to study the relationship between personality dimensions according to the psychobiological model of Cloninger and the presence of psychopathology. MATERIALS AND METHODS The study sample consisted of 42 patients with FM and 38 pain-free controls. The assessment instruments administered were the Temperament and Character Inventory-Revised and the Millon Clinical Multiaxial Inventory. RESULTS A higher proportion of clinical psychopathologic syndromes (CPS) was observed in the FM group than in the control group, the most prevalent being anxiety disorder and dysthymia. Patients with FM (with CPS or without CPS) presented higher Harm Avoidance than the control group, and the presence of a CPS also increased Harm Avoidance scores. FM patients with CPS had low Self-directedness (SD) compared with both the control group and with their FM peers without CPS. Purposefulness and Anticipatory worry-Pessimism explained 38% of the variance of dysthymia, and anticipatory worry-Pessimism explained 18% of the variance of anxiety disorders. CONCLUSIONS Patients with FM have a high probability of anxious-depressive-type psychopathologic alterations. Their vulnerability to these conditions may be determined by personality traits. The SD character dimension may have implications for therapy, as low SD is associated with the presence of psychopathology and with a low capacity to cope with the disease.
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Cheng H, Treglown L, Green A, Chapman BP, Κornilaki EN, Furnham A. Childhood onset of migraine, gender, parental social class, and trait neuroticism as predictors of the prevalence of migraine in adulthood. J Psychosom Res 2016; 88:54-8. [PMID: 27521654 DOI: 10.1016/j.jpsychores.2016.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 07/16/2016] [Accepted: 07/21/2016] [Indexed: 12/21/2022]
Abstract
This study investigated the effects of socio-demographic and psychological factors in childhood and adulthood on the prevalence of migraine in adulthood using data from The National Child Development Studies (NCDS), a birth cohort in the UK. The analytical sample comprises 5799 participants with complete data. Logistic regression analysis showed that higher professional parental social class (OR=2.0: 1.05, 3.86, p<0.05), female sex (OR=2.24: 1.68-2.99, p<0.001), migraine in childhood diagnosed by physicians (OR=1.76: 1.23-2.50, p<0.01), and higher trait neuroticism (OR=1.17:1.26-1.06, p<0.01):<0 were all significantly associated with the prevalence of migraine in adulthood. Both socio-demographic and personality factors were significantly associated with the prevalence of migraine in adulthood.
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Affiliation(s)
- Helen Cheng
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK; ESRC Centre for Learning and Life Chances in Knowledge Economies and Societies, Institute of Education, University College London, London WC1H 0AL, UK
| | - Luke Treglown
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK
| | - Andy Green
- ESRC Centre for Learning and Life Chances in Knowledge Economies and Societies, Institute of Education, University College London, London WC1H 0AL, UK
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester, School of Medicine and Dentistry, 300 Crittendon, Rochester, NY 14642, USA
| | | | - Adrian Furnham
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK; BI: Norwegian Business School, Nydalsveien 37, 0484 Oslo, Norway.
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Leombruni P, Zizzi F, Miniotti M, Colonna F, Castelli L, Fusaro E, Torta R. Harm Avoidance and Self-Directedness Characterize Fibromyalgic Patients and the Symptom Severity. Front Psychol 2016; 7:579. [PMID: 27199814 PMCID: PMC4842927 DOI: 10.3389/fpsyg.2016.00579] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/07/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Evidence in the literature suggests peculiar personality traits for fibromyalgic (FM) patients, and it has been suggested that personality characteristics may be involved in patients' different symptomatic events and responses to treatment. The aim of the study is to investigate the personality characteristics of Italian FM patients and to explore the possibility of clustering them considering both personality traits and clinical characteristics. DESIGN The study used a cross-sectional methodology and involved a control group. A self-assessment procedure was used for data gathering. The study included 87 female FM patients and 83 healthy females. Patients were approached and interviewed in person during a psychiatric consultation. Healthy people were recruited from general practices with previous telephone contact. MAIN OUTCOME MEASURES Participants responded to the Hospital Anxiety and Depression Scale, the Temperament and Character Inventory, the Fibromyalgia Impact Questionnaire and the Short-Form-36 Health Survey. RESULTS FM patients scored significantly different from healthy participants on the Harm avoidance (HA), Novelty seeking (NS) and Self-directedness (SD). Two clusters were identified: patients in Cluster1 (n = 37) had higher scores on HA and lower scores on RD, SD, and Cooperativeness and reported more serious fibromyalgia and more severe anxious-depressive symptomatology than did patients in Cluster2 (n = 46). CONCLUSION This study confirms the presence of certain personality traits in the FM population. In particular, high levels of HA and low levels of SD characterize a subgroup of FM patients with more severe anxious-depressive symptomatology. According to these findings, personality assessment could be useful in the diagnostic process to tailor therapeutic interventions to the personality characteristics.
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Affiliation(s)
- Paolo Leombruni
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Francesca Zizzi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Marco Miniotti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Fabrizio Colonna
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Azienda Ospedaliero-Universitaria Cittá della Salute e della Scienza di Torino Turin, Italy
| | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
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Gustin SM, Burke LA, Peck CC, Murray GM, Henderson LA. Pain and Personality: Do Individuals with Different Forms of Chronic Pain Exhibit a Mutual Personality? Pain Pract 2015; 16:486-94. [PMID: 25858277 DOI: 10.1111/papr.12297] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 11/23/2014] [Accepted: 02/11/2015] [Indexed: 01/03/2023]
Abstract
The role of personality in the experience of chronic pain is a growing field, with endless debate regarding the existence of a "pain personality". This study aims to compare different chronic pain types and consolidate the existence of a common personality. Thirty-two females with chronic orofacial pain and 37 age-matched healthy females were assessed with the Temperament and Character Inventory-Revised. Chronic pain subjects had either trigeminal neuropathy (neuropathic pain) or temporomandibular disorders (nociceptive pain). This study revealed that individuals with different chronic pain types exhibit a mutual personality profile encompassing significantly higher scores in Harm Avoidance and significantly lower scores in Self-Directedness when compared to healthy subjects. In fact, this combination is associated with Cluster C personality disorders. In conclusion, our study reveals that irrespective of type, chronic pain may be associated with Cluster C personality disorders. Indeed, there has never been empirical evidence in the past to suggest that chronic pain as an overall concept is associated with any particular personality disorders. Therefore, a potential future avenue of chronic pain treatment may lie in targeting particular personality aspects and shift the target of pain-relieving treatments from sensory and psychologically state focused to psychologically trait focused.
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Affiliation(s)
- Sylvia M Gustin
- Neuroscience Research Australia, Sydney, Australia.,Department of Anatomy & Histology, University of Sydney, Sydney, Australia.,School of Psychology, University of New South Wales, Sydney, Australia
| | - Lucinda A Burke
- Department of Anatomy & Histology, University of Sydney, Sydney, Australia
| | - Chris C Peck
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Greg M Murray
- Jaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Luke A Henderson
- Department of Anatomy & Histology, University of Sydney, Sydney, Australia
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Garcia-Fontanals A, García-Blanco S, Portell M, Pujol J, Poca-Dias V, García-Fructuoso F, López-Ruiz M, Gutiérrez-Rosado T, Gomà-I-Freixanet M, Deus J. Cloninger's psychobiological model of personality and psychological distress in fibromyalgia. Int J Rheum Dis 2014; 19:852-63. [PMID: 25483854 DOI: 10.1111/1756-185x.12473] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Personality can play an important role in the clinical symptoms of fibromyalgia (FM). The aim of this study is to identify personality profiles in FM patients and the possible presence of personality disorder (PD) from the Temperament and Character Inventory-Revised (TCI-R), and to assess whether personality dimensions are related to psychological distress in FM. METHOD The sample consisted of 42 patients with FM and 38 healthy controls. The TCI-R, Hospital Anxiety and Depression Scale, State-Trait Anxiety Inventory, Short-Form-36 Health Survey, Fibromyalgia Impact Questionnaire and McGill Pain Questionnaire were administered. RESULTS The personality profile of the FM group based on the TCI-R is defined by high Harm Avoidance (HA), low Novelty Seeking (NS), and low Self-Directedness (SD). Only one-third of patients with FM present a possible psychometric PD, principally from Cluster C. In the FM group, HA and SD are associated positively and negatively, respectively, with indicators of emotional distress. Patients with higher HA present higher perceived pain intensity rated via a verbal-numerical scale while Determination (SD2) reduced the perceived level of pain induced by the stimulus. NS is negatively related to the number of work absences caused by FM. CONCLUSIONS The study suggests that HA and SD play an important role in psychological distress in FM. The fact that SD is prone to modification and has a regulatory effect on emotional impulses is a key aspect to consider from the psychotherapeutic point of view.
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Affiliation(s)
- Alba Garcia-Fontanals
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain.
| | | | - Mariona Portell
- Department of Psychobiology and Methodology of Health Sciences, Autonomous University of Barcelona, Barcelona, Spain
| | - Jesús Pujol
- MRI Research Unit, CRC Mar, Hospital del Mar, Barcelona, Spain.,CIBERSAM G21, Spain
| | | | | | | | - Teresa Gutiérrez-Rosado
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Joan Deus
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain. .,MRI Research Unit, CRC Mar, Hospital del Mar, Barcelona, Spain.
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Gümüşer F, Altinbaş K, Çağlar İM, Ungan İ. Comparison of Temperamental Features, Anxiety, and Depression Levels Between Non-Cardiac Angina and Acute Coronary Syndrome. Noro Psikiyatr Ars 2014; 51:363-367. [PMID: 28360655 DOI: 10.5152/npa.2014.6789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 04/13/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In many studies that are aimed to determine the psychological profile of patients admitted to the emergency unit with non-cardiac angina (NCA), it was indicated that psychiatric problems, less effective problem-solving, and alexithymia are more common in NCA compared with acute coronary syndrome (ACS) patients. In this study, aiming to find predictive psychological clinical features, we compared the temperament, anxiety, and depression scores of patients with NCA and ACS. METHODS Sociodemographic variables of 63 patients (n=41 NCA, n=22 ACS) who were admitted to the emergency unit with chest pain were recorded. TEMPS-A scale was used for defining temperamental features, and Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression levels of patients in both groups. Sociodemographic variables and TEMPS-A and HADS scores were compared with χ2 and independent-groups t-test between the NCA and ACS groups. RESULTS The NCA and ACS groups were similar in terms of sociodemographic variables. There was no statistical difference between groups in HDS (p=.12) and HAS (p=.39) scores and TEMPS-A scale depressive (p=.41), cyclothymic (p=.08), hyperthymic (p=.06), and anxious (p=.29) temperament scores. But, irritable temperament scores were significantly higher in the NCS group (p=.04). CONCLUSION We believe that our findings will provide a basis for further studies in the diagnosis and treatment of NCA by contributing to the definition of NCA patients' psychological profiles.
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Affiliation(s)
- Fatih Gümüşer
- Clinic of Cardiology, Private Acıbadem Hospital, İstanbul, Turkey
| | - Kürşat Altinbaş
- Department of Psychiatry, Çanakkale Onsekiz Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - İlker Murat Çağlar
- Clinic of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - İsmail Ungan
- Clinic of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
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Altunayoglu Cakmak V, Gazioglu S, Can Usta N, Ozkorumak E, Ayar A, Topbas M, Boz C. Evaluation of temperament and character features as risk factors for depressive symptoms in patients with restless legs syndrome. J Clin Neurol 2014; 10:320-7. [PMID: 25324881 PMCID: PMC4198713 DOI: 10.3988/jcn.2014.10.4.320] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 05/10/2014] [Accepted: 05/13/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Restless legs syndrome (RLS) is a common sleep-related movement disorder that is frequently associated with psychological disturbances. Personality traits are of considerable importance with respect to coping with chronic illness and disease vulnerability. This study assessed the temperament and character traits of RLS patients using an approach that involves the psychobiological model of personality. METHODS The personality features of 65 newly diagnosed and untreated RLS patients with no neurological or psychiatric diseases and 109 healthy controls were determined using the Temperament and Character Inventory and compared using covariance analyses. The International RLS Study Group Severity Scale was used to assess the severity of the RLS symptoms, and the Beck Depression Inventory was used to assess the presence and severity of depressive symptoms. RESULTS RLS patients scored significantly higher than healthy controls on the temperament dimension of harm avoidance (HA, p=0.02) and significantly lower on self-directedness (SD, p=0.001). No significant difference was observed in terms of the temperament dimension of novelty seeking (p=0.435). HA scores were significantly correlated with the BDI score but not with the RLS severity or duration. CONCLUSIONS High HA and low SD scores are the main characterizing personality features of RLS patients. These personality dimensions may be among the factors predisposing patients to development of the depressive symptoms that are frequently associated with RLS.
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Affiliation(s)
| | - Sibel Gazioglu
- Department of Neurology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Nuray Can Usta
- Department of Neurology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Evrim Ozkorumak
- Department of Psychiatry, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Ahmet Ayar
- Department of Physiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Murat Topbas
- Department of Public Health, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Cavit Boz
- Department of Neurology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
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Saribacak A, Altinbaş K, Yilmaz H, Özkan A, Özkan L, Oral T. Affective Temperament Profiles of Overactive Bladder Patients. Noro Psikiyatr Ars 2014; 51:263-266. [PMID: 28360636 DOI: 10.4274/npa.y6889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/05/2013] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Overactive bladder (OAB) is generally characterized by urinary urgency with or without incontinence and increased frequency of voiding and nocturia. Although animal studies have demonstrated the relationship between defective serotonergic neurotransmission and OAB, its etiology is still unclarified. Temperament profiles are hypothesized to be related with serotonergic activity and are studied in many psychosomatic disorders. Thus, we assume that OAB is related with a certain type of temperament. METHOD 29 patients, who were admitted to the urology outpatient clinic at Kocaeli University and clinically diagnosed with OAB syndrome, were recruited for the study. Temperament profiles were evaluated with the Temperament Evaluation of Memphis Pisa Paris and San Diego Autoquestionnaire (TEMPS-A). Depressive, hyperthymic, cyclothymic, anxious and irritable temperament scores in patients were compared with those in 25 healthy controls. RESULTS Patient and control groups were similar in terms of age (p=.65), sex (p=.64) and educational level (p=.90). Anxious temperament scores were higher (p=.02) and hyperthymic temperament scores were lower (p=.02) in patients with OAB compared to controls. Depressive, cyclothymic and irritable temperament scores were similar in both groups. There was no significant differences between men and women in both groups in terms of different temperament profile scores. CONCLUSION Hypothetically, there might be an association between anxious temperament and OAB syndrome reflecting serotonergic dysfunction. However, OAB syndrome must be considered from the aspect of the interdependence of psychosomatic implications in a narrow sense and psychosomatic dimensions due to the psychological predisposition in the individual case.
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Affiliation(s)
| | - Kürşat Altinbaş
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Psychiatry, Çanakkale, Turkey
| | - Hasan Yilmaz
- Seka State Hospital, Clinic of Urology, Kocaeli, Turkey
| | - Alp Özkan
- Kocaeli University Faculty of Medicine, Department of Urology, Kocaeli, Turkey
| | - Levend Özkan
- Kocaeli University Faculty of Medicine, Department of Urology, Kocaeli, Turkey
| | - Timuçin Oral
- İstanbul Commerce University, Department of Psychology, İstanbul, Turkey
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Personality traits of patients with multiple sclerosis and their relationship with clinical characteristics. J Nerv Ment Dis 2014; 202:408-11. [PMID: 24727727 DOI: 10.1097/nmd.0000000000000114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Few studies have investigated personality characteristics in people with multiple sclerosis (MS), and little is known about the relationship between personality and clinical characteristics in these patients. We aimed to investigate the personality traits of MS patients and their relationship with clinical characteristics. The study population consisted of 74 MS patients and age-matched, sex-matched, and education level-matched healthy controls. All participants were instructed to complete the self-administered 240-item Temperament and Character Inventory and the Beck Depression Inventory. The MS patients exhibited higher harm avoidance (HA) and lower self-directedness scores than the control group, although these differences disappeared after controlling for depression. Duration of the disease was positively correlated with HA and negatively correlated with novelty-seeking scores. Expanded Disability Status Scale scores were negatively correlated with reward dependence. Our results suggest a possible relationship between personality characteristics and the stage of the disease or the degree of damage in MS patients.
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Kukulj S, Margetic BA, Jakovljevic M, Samarzija M. Temperament and character and quality of life in lung cancer patients. TUMORI JOURNAL 2013; 99:708-14. [DOI: 10.1177/030089161309900611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim The aim of this study was to test whether personality variables are independently associated with health-related quality of life (HRQOL) in lung cancer patients. Methods In a cross-sectional study, 86 non-small cell lung cancer patients and 73 healthy subjects matched for gender and age were assessed with the Temperament and Character Inventory. In the patient group QOL was assessed with EORTC QLQ-C30. We used multiple linear regressions to determine whether personality dimensions predict HRQOL. Data on tumor stage, patient age, education and marital status were also collected. Results Lung cancer patients differed from healthy controls in the temperament dimension of persistence and the character dimension of self-transcendence. The temperament dimension of harm avoidance and the character dimension of cooperativeness were significant predictors of QOL functional scales and global health status. Conclusions In lung cancer patients, the personality dimensions of harm avoidance and cooperativeness showed associations with most QOL dimensions. Personality factors are relevant for patients' QOL perception and should be included in cancer patients' QOL assessment.
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Affiliation(s)
| | | | - Miro Jakovljevic
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
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17
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Aukst Margetić B, Kukulj S, Šantić Ž, Jakšić N, Jakovljević M. Predicting depression with temperament and character in lung cancer patients. Eur J Cancer Care (Engl) 2013; 22:807-14. [DOI: 10.1111/ecc.12080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2013] [Indexed: 12/31/2022]
Affiliation(s)
- B. Aukst Margetić
- Department of Psychiatry; University Hospital Center Zagreb; Zagreb Croatia
| | - S. Kukulj
- Department of Pulmonary Diseases Jordanovac; University Hospital Center Zagreb; Zagreb Croatia
| | - Ž. Šantić
- University School of Medicine Mostar; Mostar Bosnia and Herzegovina
| | - N. Jakšić
- Department of Psychiatry; University Hospital Center Zagreb; Zagreb Croatia
| | - M. Jakovljević
- Department of Psychiatry; University Hospital Center Zagreb; Zagreb Croatia
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Knaster P, Estlander AM, Karlsson H, Kaprio J, Kalso E. Temperament traits and chronic pain: the association of harm avoidance and pain-related anxiety. PLoS One 2012; 7:e45672. [PMID: 23133510 PMCID: PMC3485083 DOI: 10.1371/journal.pone.0045672] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 08/23/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Anxiety symptoms are common in chronic pain patients. High levels of anxiety are associated with increased pain experience and disability. Proneness to anxiety has a large interindividual variation. The aim of the study was to determine whether the anxiety-related temperament trait Harm Avoidance (HA), is associated with pain-related anxiety. METHODS One hundred chronic pain patients in a multidisciplinary pain clinic participated in the study. The patients were assessed using the HA scale of the Temperament and Character Inventory (TCI) of Cloninger and Pain Anxiety Symptoms Scale-20 (PASS-20). Both the HA total score and the four subscales of HA were analyzed. Current pain intensity was measured using the Visual Analogue Scale (VAS). The Beck Depression Inventory (BDI) was used to control for the influence of depression on the personality measurement. RESULTS The HA total score was associated with PASS-20, but the association became non-significant after controlling for depression. The HA4 Fatigability subscale was associated with the PASS scales. Depression did not influence this association. Pain intensity was not correlated with HA or the PASS scales. However, the association between HA4 Fatigability and PASS was influenced by pain intensity. Higher pain intensity was associated with stronger association between the scales. CONCLUSION Harm Avoidance, representing temperament and trait-related anxiety, has relevance in pain-related anxiety. Assessing personality and temperament may deepen the clinician's understanding of the pain experience and behavior in chronic pain patients.
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Affiliation(s)
- Peter Knaster
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
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20
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Campo JV. Annual research review: functional somatic symptoms and associated anxiety and depression--developmental psychopathology in pediatric practice. J Child Psychol Psychiatry 2012; 53:575-92. [PMID: 22404290 DOI: 10.1111/j.1469-7610.2012.02535.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Medically unexplained physical symptoms, commonly referred to as functional somatic symptoms (FSS), are common in pediatric medical settings and associated with suffering, impairment, and medical help seeking. The association of pediatric FSS with anxiety and depressive symptoms and disorders across the life span is reviewed. METHOD Review and critique of controlled studies examining cross-sectional and longitudinal associations of FSS with anxiety and depressive symptoms and disorders in community-based and clinical samples of children and adolescents. RESULTS FSS are consistently associated cross-sectionally with anxiety and depressive symptoms and disorders in childhood and adolescence, and the likelihood of associated anxiety and depression increases with the number of reported FSS. The presence of one or more FSS early in life is associated with an increased likelihood of multiple FSS and anxiety and depressive symptoms and disorders later in life, and anxiety and depressive symptoms and disorders in childhood are associated with subsequent multiple FSS. CONCLUSION Strong associations between FSS, anxiety, and depression across the life span suggest the need to reconsider existing nosology and reconceptualize symptomatic relationships. Large, population-based longitudinal studies of FSS, anxiety, and depressive symptoms and disorders are needed to establish temporal relationships between the various symptoms and conditions.
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Affiliation(s)
- John V Campo
- Department of Psychiatry, Professor and chair, The Ohio State University, Columbus, Ohio, USA
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Chen W, Yu S, Zhu J, Chai H, He W, Wang W. Personality characteristics of male sufferers of chronic tension-type and cervicogenic headache. J Clin Neurol 2012; 8:69-74. [PMID: 22523516 PMCID: PMC3325435 DOI: 10.3988/jcn.2012.8.1.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2010] [Revised: 05/26/2011] [Accepted: 05/26/2011] [Indexed: 11/26/2022] Open
Abstract
Background and Purpose Chronic tension-type headache (a primary headache disorder) and cervicogenic headache (a secondary headache disorder that is attributable to upper cervical spine pathology) share similar clinical manifestations, but their associated personality traits may differ. We evaluated the personality differences between sufferers of chronic tension-type headache and cervicogenic headache. Methods We administered the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) and the Zuckerman Sensation-Seeking Scale (SSS) to 18 patients suffering from chronic tension-type headache, 19 suffering from cervicogenic headache, and 26 healthy volunteers. Depressive trends were measured with the Plutchik-van-Praag Depression Inventory (PVP). Results Compared to healthy controls, the chronic tension-type headache group scored significantly higher on ZKPQ Neuroticism-Anxiety and on the PVP, while the cervicogenic headache group scored significantly lower on SSS Thrill and Adventure Seeking. In addition, the total SSS score was significantly lower in the cervicogenic headache group than in both the chronic tension-type headache group and the healthy controls. Conclusions The results of this study indicate that higher scores for neuroticism-anxiety and depression were associated with chronic tension-type headache, while lower sensation-seeking scores were associated with cervicogenic headache.
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Affiliation(s)
- Wanzhen Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University School of Sciences, Hangzhou, China
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Gulec MY, Gulec H, Oztuna F, Kose S. Cloninger's temperament and character dimension of personality in patients with asthma. Int J Psychiatry Med 2011; 40:273-87. [PMID: 21166338 DOI: 10.2190/pm.40.3.d] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Psychosocial factors have been implicated as being important in the onset and/or exacerbation of asthma. This study was performed to evaluate the personality profiles of asthma patients. METHOD Ninety-five asthmatic, 98 psoriatic patients, and 96 healthy controls completed the Temperament and Character Inventory (TCI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The relationships between asthma illness duration, asthma severity score, depression, anxiety, and temperament and character personality variables were evaluated. RESULTS Asthmatic patients had significantly higher mean scores on the BAI, Harm Avoidance, Persistence, and Self-transcendence dimensions and lower scores on the BDI, Novelty Seeking, and Reward Dependence dimensions of the TCI than the psoriatic patients. Significant group effect was found for the BDI and BAI scores in between groups. Significant differences in TCI scores were found across groups except for Persistence and Self-transcendence. Post hoc tests revealed significantly lower Novelty Seeking, higher Harm Avoidance, lower Reward Dependence, and higher Self-transcendence scores in patients with asthma. Regression analysis revealed a significant effect between duration of illness and Persistence and Self-transcendence. Illness severity had a significant effect on the Harm Avoidance. Anxiety scores had significant effect on the Harm Avoidance, Self-directedness, and Self-transcendence. Depression scores had no significant effect on any of the TCI dimensions. CONCLUSIONS Asthmatic patients can be distinguished by a specific pattern of temperament (low NS) and character (high ST) dimensions and compared with both psoriatic patients and healthy controls. Illness duration is associated with ST scores, and illness severity is associated with HA.
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Santos DDM, Lage LV, Jabur EK, Kaziyama HHS, Iosifescu DV, Lucia MCSD, Fraguas R. The association of major depressive episode and personality traits in patients with fibromyalgia. Clinics (Sao Paulo) 2011; 66:973-8. [PMID: 21808861 PMCID: PMC3129941 DOI: 10.1590/s1807-59322011000600009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/28/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Personality traits have been associated with primary depression. However, it is not known whether this association takes place in the case of depression comorbid with fibromyalgia. OBJECTIVE The authors investigated the association between a current major depressive episode and temperament traits (e.g., harm avoidance). METHOD A sample of 69 adult female patients with fibromyalgia was assessed with the Temperament and Character Inventory. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview severity of depressive symptomatology with the Beck Depression Inventory, and anxiety symptomatology with the IDATE-state and pain intensity with a visual analog scale. RESULTS A current major depressive episode was diagnosed in 28 (40.5%) of the patients. They presented higher levels of harm avoidance and lower levels of cooperativeness and self-directedness compared with non-depressed patients, which is consistent with the Temperament and Character Inventory profile of subjects with primary depression. However, in contrast to previous results in primary depression, no association between a major depressive episode and self-transcendence was found. CONCLUSIONS The results highlight specific features of depression in fibromyalgia subjects and may prove important for enhancing the diagnosis and prognosis of depression in fibromyalgia patients.
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Affiliation(s)
- Danyella de Melo Santos
- Department and Institute of Psychiatry, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
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Yalug I, Selekler M, Erdogan A, Kutlu A, Dundar G, Ankarali H, Aker T. Correlations between alexithymia and pain severity, depression, and anxiety among patients with chronic and episodic migraine. Psychiatry Clin Neurosci 2010; 64:231-8. [PMID: 20602723 DOI: 10.1111/j.1440-1819.2010.02093.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Some studies have found elevated alexithymia among patients with chronic pain, but the correlations between alexithymia and the severity of pain, depression, and anxiety among migraine patients are unclear. The aims of the present study were to investigate whether individuals suffering from episodic migraine (EM) differ from those with chronic migraine (CM) in regards to depression, anxiety, and alexithymia measures and to investigate the association of alexithymia with the results of depression and anxiety test inventories and illness characteristics. METHODS A total of 165 subjects with EM and 135 subjects with CM were studied. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Toronto Alexithymia Scale (TAS) were administered to all subjects. The correlation between alexithymia and sociodemographic variables, family history of migraine and illness characteristics (pain severity, frequency of episode, duration of illness) were evaluated. RESULTS Compared with EM patients, the CM patients had significantly higher scores on measures of depression but not alexithymia and anxiety. There was a positive correlation between TAS scores and age and education in both migraine groups, but there was no correlation between TAS scores and other demographic variables. Depression and anxiety were significantly correlated with alexithymia in both migraine groups. CONCLUSION Our results indicate that CM patients are considerably more depressive than EM patients. In this study, depression and anxiety were significantly correlated with alexithymia in both migraine groups. Our results demonstrate a positive association between depression, anxiety, and alexithymia in migraine patients.
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Affiliation(s)
- Irem Yalug
- Department of Psychiatry, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey.
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Lundberg G, Anderberg UM, Gerdle B. Personality Features in Female Fibromyalgia Syndrome. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/10582450902820531] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pilarska E, Olszewska A. Temperament traits of children with episodic tension-type headaches. Eur J Paediatr Neurol 2009; 13:327-31. [PMID: 18692419 DOI: 10.1016/j.ejpn.2008.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 05/26/2008] [Accepted: 06/20/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND The association between headache and stress is discussed. A powerful source of stress and the ways of relation between stress and headache can differed. The individual vulnerability to stress may be related to one's temperament. OBJECTIVE The purpose of the present study was to evaluate the role of temperament traits in children with episodic tension-type headaches (ETTH). METHODS We examined 120 children, 6-16 years of age, in the Department of Developmental Neurology of the Medical University of Gdansk. All children were diagnosed with ETTH. The control group consisted of 60 age-matched children without headaches. The following instruments of assessment were used: survey-interview, EAS Temperament Survey (Buss and Plomin), and Stress Response Scale (Chandler). The results were evaluated using statistical analysis. RESULTS Our results showed differences in temperament traits in children with ETTH compared to children without headaches. The former demonstrated greater temperament instability, i.e., higher emotionality, an intensified level of fear, a lower level of vigour, and a higher level of shyness compared to the control group. CONCLUSION Children with ETTH have some different traits than children without headache.
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Affiliation(s)
- Ewa Pilarska
- Department of Developmental Neurology, Medical University of Gdansk, Gdańsk, Poland.
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Battistutta S, Aliverti R, Montico M, Zin R, Carrozzi M. Chronic tension-type headache in adolescents. Clinical and psychological characteristics analyzed through self- and parent-report questionnaires. J Pediatr Psychol 2008; 34:697-706. [PMID: 18927182 DOI: 10.1093/jpepsy/jsn102] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To analyze the relation between the symptoms reported by adolescents with chronic tension-type headache (CTTH) and their perception of their emotional and behavioral functioning. METHODS Two groups of adolescents (clinical group, n = 48; control group, n = 135) and their parents (clinical group, n = 42; control group, n = 128) were studied, respectively, with the Youth Self-Report Questionnaire and the Child Behavior Checklist. Moreover, a secondary analysis was performed, identifying another subgroup of adolescents who reported having headaches. RESULTS The clinical group of adolescents obtained higher scores than the control group in Internalizing Syndrome; Aggressive Behavior for Externalizing Syndrome; Social, Thought, and Attention Problems; and in all Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)-oriented scales (except conduct problems). Differences between the two groups of parents were found in all the scales. The controls reporting headaches obtained interesting intermediate scores. CONCLUSIONS Adolescents with CTTH show greater emotional and behavioral problems than their healthy peers. Consequently, clinical approaches for proper diagnosis and treatment need to adopt a multidisciplinary prospective.
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Affiliation(s)
- Sara Battistutta
- Child Neurology and Psychiatry Ward, Department of Pediatric, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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Lambourne C, Lampasso J, Buchanan WC, Dunford R, McCall W. Malocclusion as a risk factor in the etiology of headaches in children and adolescents. Am J Orthod Dentofacial Orthop 2008; 132:754-61. [PMID: 18068593 DOI: 10.1016/j.ajodo.2006.03.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 02/20/2006] [Accepted: 03/06/2006] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to determine the importance of occlusal factors in recurrent headaches in children and adolescents without other signs or symptoms of temporomandibular disorders or related craniomandibular disorders. METHODS A sample of 50 children and adolescents, ages 8 to 16, who reported headaches was obtained from the University at Buffalo Orthodontic Clinic records; a control group of 50 children and adolescents, matched for age and sex, was also obtained. Plaster models, made during the routine collection of orthodontic records, were used to obtain the following occlusal trait measurements: Angle classification, overjet, anterior and posterior crossbite, scissors-bite, overbite, open bite, dental midline discrepancy, crowding, spacing, and dental development stage. RESULTS Overbite, overjet, and posterior crossbite showed statistically significant associations (chi-square) with increased risk for headaches. Logistic regression analysis demonstrated that overjet was a significant factor only because of its correlation with overbite and posterior crossbite. Overjet was not significant after adjusting for the other 2 variables, whereas overbite and posterior crossbite were associated with significantly increased risk (>3:1) of headache. The combination of 2 or more of these 3 occlusal factors increased the risk of headache even more (8.5:1). CONCLUSIONS Posterior crossbite and overbite > or =5 mm were associated with significantly increased risk of headache in children and adolescents.
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Affiliation(s)
- Chad Lambourne
- Department of Orthodontics, School of Dental Medicine, State University of New York, Buffalo, NY 14214, USA
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Boz C, Gazioglu S, Altunayoglu V, Hocaoglu C. Effect of serotonergic antidepressant therapy on temperament and character scales in patients with chronic tension-type headache. Psychiatry Clin Neurosci 2007; 61:534-42. [PMID: 17875033 DOI: 10.1111/j.1440-1819.2007.01704.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of the present study was to assess a group of patients with chronic tension-type headache (CTTH) and control subjects using the personality questionnaire proposed by Cloninger and to determine possible changes in the Temperament and Character Inventory (TCI) patterns of CTTH patients after therapy with serotonergic antidepressants. Forty-five patients with CTTH filled out the TCI and Beck Depression Inventory (BDI) before and after 4-month prophylactic therapy with serotonergic antidepressants. A total of 50 age-, sex- and education level-matched healthy subjects were selected as a control group. During the pretreatment period patients were found to have higher harm avoidance and lower self-directedness scores than healthy comparison subjects. During the post-treatment period, although harm avoidance scores decreased and self-directedness scores increased, harm avoidance scores were still significantly higher and self-directedness scores significantly lower in CTTH patients than in controls. After using BDI score and age as covariates at the post-treatment period, harm avoidance scores were still higher in patients with CTTH while self-directedness scores did not differ between CTTH patients and controls. These findings suggest state and trait dependence of harm avoidance, and strong state dependence of self-directedness scores in CTTH patients. When interpreting data regarding personality measured by the TCI in CTTH patients, the effects of depressive symptomatology should be taken into account.
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Affiliation(s)
- Cavit Boz
- Department of Neurology, Medical Faculty of Karadeniz Technical University, Trabzon, Turkey.
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Abbate-Daga G, Fassino S, Lo Giudice R, Rainero I, Gramaglia C, Marech L, Amianto F, Gentile S, Pinessi L. Anger, depression and personality dimensions in patients with migraine without aura. PSYCHOTHERAPY AND PSYCHOSOMATICS 2007; 76:122-8. [PMID: 17230053 DOI: 10.1159/000097971] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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.
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Affiliation(s)
- Giovanni Abbate-Daga
- Psychiatry Section, Department of Neuroscience, Ospedale San Giovanni Battista, Psichiatria Universitaria CPR DCA, Turin, Italy
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Abstract
Much of the contemporary literature on headache disorders focuses on migraine headaches, despite the fact that tension-type headache (TTH) is highly prevalent and can be as debilitating as migraines. This article reviews the current literature on prevalence rates of psychiatric disorders in TTH populations, psychologic factors associated with TTH, and psychiatric disorders and their relationships with treatment outcomes in TTH. Key conclusions of this review include 1) prevalence rates of TTH vary across clinical and population-based samples; 2) greater TTH chronicity is associated with increased affective distress; 3) Axis II personality disorders may play an important role in TTH prevalence rates and psychologic functioning but have been understudied to date; and 4) maladaptive coping is common in persons with TTH.
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O'Gorman RL, Kumari V, Williams SCR, Zelaya FO, Connor SEJ, Alsop DC, Gray JA. Personality factors correlate with regional cerebral perfusion. Neuroimage 2006; 31:489-95. [PMID: 16529951 DOI: 10.1016/j.neuroimage.2005.12.048] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2005] [Revised: 12/06/2005] [Accepted: 12/16/2005] [Indexed: 11/17/2022] Open
Abstract
There is an increasing body of evidence pointing to a neurobiological basis of personality. The purpose of this study was to investigate the biological bases of the major dimensions of Eysenck's and Cloninger's models of personality using a noninvasive magnetic resonance perfusion imaging technique in 30 young, healthy subjects. An unbiased voxel-based analysis was used to identify regions where the regional perfusion demonstrated significant correlation with any of the personality dimensions. Highly significant positive correlations emerged between extraversion and perfusion in the basal ganglia, thalamus, inferior frontal gyrus and cerebellum and between novelty seeking and perfusion in the cerebellum, cuneus and thalamus. Strong negative correlations emerged between psychoticism and perfusion in the basal ganglia and thalamus and between harm avoidance and perfusion in the cerebellar vermis, cuneus and inferior frontal gyrus. These observations suggest that personality traits are strongly associated with resting cerebral perfusion in a variety of cortical and subcortical regions and provide further evidence for the hypothesized neurobiological basis of personality. These results may also have important implications for functional neuroimaging studies, which typically rely on the modulation of cerebral hemodynamics for detection of task-induced activation since personality effects may influence the intersubject variability for both task-related activity and resting cerebral perfusion. This technique also offers a novel approach for the exploration of the neurobiological correlates of human personality.
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Affiliation(s)
- R L O'Gorman
- Department of Neuroimaging, Ground floor, Ruskin Wing, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
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