Exploring the association between type of pain and mental health with 4DSQ

Nurver Sipahioğlu, Aysen Kutan Fenercioğlu, Didem Kafadar, V. Selcuk Engin, Ugurcan Sayılı

Keywords: Headache, bodily pain, 4DSQ, mental health

Background:

A biopsychosocial approach is needed to assess the background of headache and pain disorders and for their effective treatment

Research questions:

What is the most prevalent mental health symptom that accompany headache and other types of pain?
Which social and demographic factors effect the relation between pain and mental symptoms?

Method:

Four dimensional symptom questionnaire (4DSQ) was selected to determine the mental health status of a total of 158 participants. The participants were seperated as groups with headache, with headache and body pain, with body pain without headache and control. A pain questionnaire searching the type, severity, duration of pain and other pain related actions along with another questionnaire on demographic data were applied to the participants.
The data were evaluated with SPSS 21, using Fischer's exact test, Kruskal Wallis, Chi2 and One way Anova.

Results:

Having multiple pain localizations besides headache increased distress and somatization scores with regard to all other three groups.
Having multiple pain localizations besides headache increased anxiety scores with regard to control group and the group with headache only. The depression scores of participants having multiple pain localizations besides headache were higher than the control group and the group with headache only. Being female and under age 46 increased the scores of 4DSQ significantly except depression which was related with older age. Having a low, irregular income and being a student or being a housewife were significantly related with depression and distress whereas being a student and housewife were significantly related with somatization and anxiety.

Conclusions:

Patients with headache are likely to have a multifaceted etiology as well as comorbidities. Psychological symptoms with varying severity might be associated with headache.
Thus, it is of paramount importance for primary health service providers not to overlook psychiatric symptoms and to interrogate pain in other regions to improve patient compliance and satisfaction.

Points for discussion:

When assessing mental health symptoms in headache, other pain localizations should also be considered which may aggrevate the patients condition.

Age, gender, income and other comorbidities have an effect on the realationship of mental health symptoms with pain disorders

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