Analysis Of Related Influencing Factors Of Chronic Tension-type Headache With Anxiety And Depression

Objective:Chronic tension-type headache(CTTH)is a type of primary headache that is very common in clinical work.Typical symptoms are bilateral head compression or cuff-like headaches,which are more than 3 months old.Tension headache is CTTH,and there is a close relationship between anxiety and depression.The purpose of this project is to analyze the current status of CTTH with anxiety and depression and its related influencing factors,to provide a basis for its preventive intervention,reduce headaches and mental and psychological burdens,and improve life quality.Methods:A total of 150 CTTH patients who were treated or inpatient in neurology clinics from March 2018 to December 2019 in the Affiliated Hospital of Hebei University were selected,aged 18 to 80 years,with an average age of 56.3±14.1 years,including 68 males and 82 females.example.All 150 patients met the third edition of the International Society of Headache Diagnostic Standards(ICDH-3).All 150 patients met the CTTH diagnostic criteria of The International Classification of Headache Disorders 3rd(ICDH-3).According to the Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)scores,Screening was performed in 150 CTTH patients.They were divided into CTTH group with anxiety and depression and CTTH group without anxiety and depression.Collect relevant data of two groups of patients separately:1.Demographics:age,gender,height,weight,marital status,education,occupation,and area of residence.2.Body mass index(BMI):weight(kg)/height(m)~2.Divided into normal,overweight,and obese according to the score.3.Physical disease:Whether it is associated with stroke,hypertension,diabetes,hypertriglyceridemia,hypercholesterolemia,and coronary atherosclerotic heart disease.4.Sleep quality:The internationally recognized Pittsburgh Sleep Quality Index Scale(PSQI)score is used for evaluation.The higher the score,the worse the sleep quality.5.Headache severity:Visual analog scale(VAS)was used to measure the score.0-10 grades.Headache severity was classified as mild,moderate,and severe according to the score.6.Course of disease:divide the boundaries by 1 year.Results:1.150 cases of CTTH patients were assessed after completing the HAMA and HAMD scales.There were 95 cases of CTTH with anxiety and depression,with a prevalence of 63.3%.2.Univariate analysis showed:gender,age,body mass index,marital status,education level,living area,6 factors,physical disease,sleep quality,headache severity,duration of disease 4factors were statistically significant in the two groups(P<0.05),may be related to CTTH associated with anxiety and depression.Multivariate Logistic regression analysis:gender,body mass index(BMI),sleep quality(PSQI score),headache severity(VAS score)and independent risk factors for anxiety and depression associated with CTTH(P<0.05).Correlation analysis results:age,BMI,physical illness,sleep quality(PSQI score),headache severity(VAS score),and course of disease were significantly positively correlated with HAMA/HAMD score(anxiety and depression),and Educational level was negatively correlated with HAMA/HAMD score(anxiety and depression)(P<0.05).3.In the CTTH with anxiety and depression group,there were 30 males(44.1%)and 65females(79.3%).The prevalence of females was significantly higher than that of males(P<0.05).Women are an independent risk factor for anxiety and depression associated with CTTH.In CTTH patients,women are five times more likely to suffer from anxiety and depression than women,and women are more likely to have anxiety and depression.4.The prevalence of anxiety and depression among the ages of 18-45,46-69 and 70 and above were 13.8%,73.5%and 82.6%,respectively,and the differences were statistically significant(P<0.05).At the same time,age was positively correlated with anxiety and depression(r_s=0.488,P<0.001).As the severity of headache increased,the associated anxiety and depression increased.5.The prevalence of anxiety and depression associated with CTHH with normal BMI and overweight/obesity were 20.5%and 78.4%,the difference was statistically significant(P<0.05).BMI is an independent risk factor for anxiety and depression associated with CTTH.Overweight/obese CTTH patients are 7 times more likely to have anxiety and depression than normal weight.Overweight or obese CTTH patients are at high risk and are more likely to develop anxiety and depression.At the same time,BMI was positively correlated with anxiety and depression(r_s=0.527,P<0.001).As the weight increased,the greater the anxiety and depression associated with it.6.In the CTTH with anxiety and depression group,the prevalence of anxiety and depression with sleep quality scores PSQI?7 and>7 was 17.0%and 84.5%,and the difference was statistically significant(P<0.05).Sleep quality is an independent risk factor for CTTH with anxiety and depression.CTTH patients with poor sleep quality are 11 times more likely to have anxiety and depression than those with good sleep quality.CTTH patients with poor sleep quality(PSQI>7 points)are at higher risk of anxiety and depression.Sleep quality(PSQI score)was positively correlated with anxiety and depression(r_s=0.649,P<0.001).As the quality of sleep was worse,anxiety and depression were associated with it.7.Headache severity VAS scores 1-3(mild),4-6(moderate),and 7-10(severe)CTTH The prevalence of anxiety and depression in CTTH patients was 16.0%,69.1%,and 100.0%,The difference was statistically significant(P<0.05).CTTH patients with more severe headaches have a higher risk of anxiety and depression.At the same time,headache severity(VAS score)was positively correlated with anxiety and depression(r_s=0.471,P<0.001).As the severity of headache increased,the associated anxiety and depression increased.8.The prevalence of anxiety and depression in patients with disease course within 1 year and more than 1 year was 22.2%and 81.0%,the difference was statistically significant(P<0.05).The course of disease was positively correlated with the HAMA/HAMD score(anxiety and depression)(r_s=0.558,P<0.001).With the extension of the course of disease,CTTH patients were more likely to be associated with anxiety and depression.9.The prevalence of anxiety and depression in patients with and without physical disease was 27.3%and 69.5%,respectively,and the difference was statistically significant(P<0.05).Physical illness was positively correlated with HAMA/HAMD score(anxiety and depression)(r_s=0.310,P<0.001).With the presence of physical illness,CTTH patients were more likely to be associated with anxiety and depression.10.The prevalence of anxiety and depression among illiterate,elementary,middle,university and higher education educated people with different educational levels were 87.5%,58.7%,54.1%and 48.1%,with illiteracy being the highest.The difference was statistically significant(P<0.05).Educational level is negatively correlated with HAMA/HAMD score(anxiety and depression)(r_s=-0.285,P<0.001),which indicates that CTTH patients with lower educational level are more likely to be associated with anxiety and depression.11.The prevalence of anxiety and depression among unmarried,married,divorced and widowed people with different marital status were 46.7%,55.2%,80.0%and 85.7%,with widowed being the highest,followed by divorce.The difference was statistically significant(P<0.05).The prevalence of anxiety and depression in CTTH patients of different occupational students,farmers,workers,cadres,and retirees was 50.0%,75.0%,51.9%,52.4%,and 50.0%,respectively,and the differences were not statistically significant(P=0.060).The prevalence of anxiety and depression in CTTH patients in rural and urban areas in different residential areas was 72.6%and 51.5%,respectively.Rural areas were significantly higher than urban areas,and the difference was statistically significant(P<0.05).Conclusion:Chronic tension-type headache associated with anxiety and depression is affected by many factors.Gender,body mass index(BMI),sleep quality,and headache severity are independent risk factors for anxiety and depression associated with CTTH;divorce and widowed,rural areas,associated physical illness,CTTH patients with longer headache duration and lower education level are more likely to be associated with anxiety and depression.