Coping Strategies in Episodic and Chronic Tension-type Headache


Address all correspondence to Dr. Jens D. Rollnik, Department of Neurology and Clinical Neurophysiology, Medical School of Hannover, D-30623 Hannover, Germany.


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.