Coping strategies in episodic and chronic tension-type headache

Objective. - To study the importance of coping with illness strategies in t ension-type headache (TTH). Background. - The pathophysiology of TTH is complex, and coping with illnes s strategies might contribute to the transformation to a chronic form. Methods. - We examined 89 subjects (mean age, 45.6 +/- 14.8 years; range, 1 8 to 72 years) with episodic (n = 37) and chronic (n = 52) TTH. Patients we re required to fill in a Freiburg Questionnaire of Coping with Illness (FQC I), a von Zerssen Depression Scale, quality-of-life questionnaires, and a h eadache home diary (over 4 weeks). In addition, pressure pain thresholds (t emporal muscles) and total tenderness scores were obtained. Results. - Patients with chronic TTH exhibited poorer quality-of-life measu res, slightly more depressive symptoms, and significantly stronger avoidanc e behavior and endurance strategies on FQCI scales F4 and F5 (P<.05), There was no difference between episodic and chronic TTH with respect to measure s of muscle tenderness or pain thresholds. Conclusions. - We conclude that disadvantageous coping with illness strateg ies might contribute to a transformation to chronic TTH.