Stress Related Determinants of Anxiety and Depression in Young Girls with Chronic Headache

Rapid Communication

Ann Depress Anxiety. 2022; 9(1): 1113.

Stress Related Determinants of Anxiety and Depression in Young Girls with Chronic Headache

Simone Bung, Helmut Saile and Reinhold Laessle*

University of Trier, Frauenstr 7, 54290 Trier, Germany

Corresponding author: Reinhold Laessle, University of Trier, Frauenstr 7, 54290 Trier, Germany

Received: February 07, 2022; Accepted: March 02, 2022; Published: March 09, 2022

Abstract

Girls with chronic headache often suffer also from marked anxiety and depression. The present study used psychological and biological characteristics related to stress load and stress coping to predict anxiety and depression. This was done by regression analysis. Anxiety could be better explained than depression. Psychological and physiological stress load played a significant role, but not activity of HPA axis, although cortisol awakening response was heightened specifically for headache sufferers.

Keywords: Headache; Adolescents; Stress load; Stress coping; Anxiety; Depression

Introduction

Chronic headache in children and adolescents is frequent. A metaanalysis of [1] was based on data of 50 studies, which were published worldwide and included 80,000 patients. Lifetime prevalence of chronic headache was 58.4%. For migraine in particular 7, 7% are reported, whereby the prevalence for girls is greater than for boys.

Stress load in daily life of adolescents with chronic headache is heightened, which has been shown in a study of [2] in 113 school girls.

The interrelationship between stress and headache in the longterm has been confirmed also by [3].

A very high stress load in university students with chronic headache was observed in a case-control study of [4]. When a high stress load was present in young college students, headache was significantly more present than other somatic complaints [5].

School absenteeism as an indicator of stress load has been found in adolescents with chronic headache by [6].

On the other hand stress coping of youth with chronic headache is characterized by widely inadequate strategies. This has been demonstrated in a study of [7] by using projective test methods.

A long-term study of [8] found a high comorbidity of headache and anxiety as well as depression.

This was supported by [9].

A third study by [10] presented the same results.

The empirical evidence suggests that girls with headache are suffering from more stress load and on the other hand are not able to cope adequately with stress. The present investigation is an attempt to confirm previous results. As an extension to previous findings anxiety and depression were assessed and influences on these psychopathological characteristics were identified.

Methods

All participants with headache were recruited in schools and had to fulfill ICHD-3 criteria for migraine or tension-type headache. The control group was recruited on the University campus in Trier. Before participation, acute diseases were excluded by a medical doctor.

20% of the girls fulfilled the criteria for migraine, 70 % criteria for tension-type headache, the rest could not be classified definitely.

Stress load was assessed by the questionnaire for stress and stress coping for children and adolescents (SSKJ) [14].

The subscales comprise 1) Vulnerability to stress; 2) Physical symptoms of stress such as headache, stomach ache or exhaustion. 3) Psychological symptoms of stress such as depressed mood and anxiety.

Depression and anxiety of the children were measured by [12,13].

Results

Results of regression analyses to predict depression or anxiety

The multiple linear regression analyses were done systematically using different predictors related to stress load and stress coping.

Regression analysis 1

Dependent variable was depression

Predictors were psychological stress load and destructive stress coping and mean cortisol 60 minutes after awakening.

The regression equation was significant with F (3.144) = 29.9 p <0.001 and explained variance of 38%. Significant predictors were psychological stress load and destructive coping.

Regression analysis 2

Dependent variable was depression

Predictors were psychological and physiological stress load and destructive stress coping.

the regression equation was significant with F (4.143) = 22.6 p<0.001 and explained variance of 37%. Significant predictors were physiological and psychological stress load and destructive coping.

Regression analysis 3

Dependent variable was depression

Predictors were psychological and physiological stress load and constructive coping, and mean cortisol 60 minutes after awakening the regression equation was significant with F (4.148) = 26.4 p<0.001 and explained variance of 40%. Significant predictor was psychological stress load.

Regression analysis 4

Dependent variable was anxiety

Predictors were psychological stress load and destructive stress coping and mean cortisol 60 minutes after awakening.

The regression equation was significant with F (4.148) = 33.0 p<0.001 and explained variance of 39%. Significant predictors were psychological stress load and destructive coping.

Regression analysis 5

Dependent variable was anxiety

Predictors were physiological stress load and destructive coping and mean cortisol 60 minutes after awakening..

The regression equation was significant with F (4.148) = 34.5 p<0.001 with an explained variance of 48%. Significant predictors were physiological stress load and destructive coping.