Gender differences in treatment-seeking chronic headache sufferers

Objective.-To identify gender differences within a group of patients seekin g treatment for chronic headache. Previous studies of the general populatio n have reported differences in headache symptoms, frequency, disability, an d psychological distress, with women affected with more severe and disablin g symptoms than men. This study evaluated these features in a population se eking treatment. Methods.-Two hundred fifty-eight consecutive patients with headache attendi ng a university headache clinic were evaluated with questionnaires about he adache symptoms and psychological distress. Comparisons between men and wom en were made for headache symptoms, severity, frequency, trigger factors, c omorbid depression and anxiety, and response to treatment. Results.-There were no gender differences in headache symptoms, frequency, severity, and duration. Headache triggers were gender-specific, with men mo re likely to endorse exercise and women more likely to endorse stress and e xposure to odors. Psychological comorbidity was similar among men and women seeking treatment, with a mean Beck Depression Inventory score of 10 and a mean Spielberger trait anxiety score of 39 for both men and women. Disabil ity was greater in men, with 46% reporting restrictions in activities more than 3 days per week because of headache compared with 29% of women. In add ition, men were more likely to contribute headache control to external figu res than women. Conclusions.-Patients seeking treatment for chronic headache do not have th e same gender-specific differences that have been reported in general popul ation surveys. Men who seek treatment for headache are more likely to have significant disability, and are equally likely to have symptoms of depressi on and anxiety as women who seek treatment. Clinical and research investiga tions of headache triggers need to be gender-specific.