Ching-Yu Chen
Department of Family Medicine National Taiwan University Hospital
Chia-Ying Weng
Department of Psychology National Chung-Cheng University
Chin-Ying Chen
Department of Family Medicine National Taiwan University Hospital
The purpose of this study is, through a comprehensive biopsychosocial assessment, history taking, physical and biofeedback evaluation to clarify the basic clinical symptomatology of tension-type headache, then to probe into the pathophysiology mechanism and psychosocial factors about this disease. We hope that the results can be provided for an empirical foundation for clinical assessment and treatment work. This study took three years. We have recruited 58 patients with tension-type headache. We interviewed them with headache evaluation scale to collect basic clinical symptomatology. And, we tested two pathophysiological hypotheses, the muscle contraction hypothesis and the oversensitivity of autonomic nervous system hypothesis. Then, we matched 29 tension-type headache patients as headache group with 21 non-headache adults as control group, and compared the differences of physical and biofeedback evaluation, emotional response, and social resources between the two groups. About symptomatology, pulsating pain, which is used as an exclusive criterion, was found in our chronic tension-type headache patients. Although the results didn’t support the muscle contraction hypothesis and the oversensitivity of autonomic nervous system hypothesis, we can not rule out other probable pathophysiological mechanism. On psychological reaction, the anxiety emotion of headache group is higher then that of control group. On social resources, both subjectively received affective resources and material resources of headache group are lesser then those of control group. In other words, besides probable pathophysiological mechanism, higher emotional response and lesser social resources would contribute to the symptom.
Keywords: tension-type headache, bio-psycho-social model, biofeedback