Clustering of Life Events in Tension Headache Patients

Abstract

Headache is one of the most common problems and is defined as a diffused pain in the various parts of the head. Over 90% of general population has reported having a headache at least once in their lifetime. In general, pain is a universal experience and is not only understood in physiological or biochemical terms, but also has sensory, emotional and cognitive components. In addition to the cultural influence, bio-psychosocial factors seem to also have a complex relationship with pain in its expression, experience and management. Our current study focused on identifying the culture-specific life events that influence tension headaches. We compared a group of incidentally recruited out-patients (n=80) with tension headaches (TH) to an equal number of matched healthy/normal attendants visiting along with patients in different out patient departments (OPDs).All the patients were recruited based on the physicians report of consistent symptoms of TH and ruling out of any physical abnormalities that may account for their pain. All these patients were females, married and had a middle class urban background. Life Events Scale (Ghosh, 1999) was used to assess the frequency of occurrence of life events. Findings of the study reveal that a specific clustering of life events distinguishes the patients from their controls. While the patients were more bothered with financial, familial, job related and behavioral events; the control group had a higher frequency of occurrence of events pertaining to personal, interpersonal and change in financial status. Studies do indicate that stressors appear to differ as a function of different disease and global assessment of life change score have been found to contribute to pain. Across several studies culture has also been found to be a strong determinant of pain response and pain reporting behavior. The identification of culture-specific event contributing to TH might add a vital outlook towards its diagnosis and management. Though further research is warranted, these differences do suggest implications for developing more culture-specific diagnostic, preventive and intervention strategies for pain management.