Coping strategies in episodic and chronic tension-type headache

Objective. - To study the importance of coping with illness strategies in tension-type headache (TTH). Background. - The pathophysiology of TTH is complex, and coping with illness strategies might contribute to the transformation to a chronic form. Methods. - We examined 89 subjects (mean age, 45.6 +/- 14.8 years; range, 18 to 72 years) with episodic (n = 37) and chronic (n = 52) TTH. Patients were required to fill in a Freiburg Questionnaire of Coping with Illness (FQCI), a von Zerssen Depression Scale, quality-of-life questionnaires, and a headache home diary (over 4 weeks). In addition, pressure pain thresholds (temporal muscles) and total tenderness scores were obtained. Results. - Patients with chronic TTH exhibited poorer quality-of-life measures, slightly more depressive symptoms, and significantly stronger avoidance behavior and endurance strategies on FQCI scales F4 and F5 (P<.05), There was no difference between episodic and chronic TTH with respect to measures of muscle tenderness or pain thresholds. Conclusions. - We conclude that disadvantageous coping with illness strategies might contribute to a transformation to chronic TTH.