Alexithymia as a Predictor of Chronic Tension Headaches

Abstract

Alexithymia as a violation of inter-hemispheric communication which has no visible organic brain changes is now regarded as a predictor of many chronic physical and neurological diseases, but it has not yet been regarded in connection with chronic tension headaches. The authors examined 137 people with tension-type headache (33 men, 84 women) aged 30–50 years (average age 40,75 ± 6,29) in order to clarify a link to alexithymia. The diagnosis of tension headache was conducted according to the International classification of headaches, 3rd edition (beta version). The authors used the original headache diary, Toronto alexithymia scale, Hospital anxiety and depression scale, the measurement of the space under the curve of headache. It was found that the patients with alexithymia have difficulty in describing the place of headaches (the average number of word descriptors at most 1 word), distrust of doctors, abuse of analgesics and tend to use alternative medicine methods. The intensity (p = 0.0001) and the frequency of headaches (p = 0.0028) is significantly higher in patients with alexithymia, and the more common are depression (p = 0.042) and impaired nocturnal sleep (p = 0.001). Patients with chronic tension-type headache associated with sleep disorders, adaptation and symptoms of depression should be considered as alexithymic personalities until the contrary is proved. Physicians should be aware of the fact that alexithymic patients have problems with feelings verbalization, and if patient’s complaints are vague a doctor should use questionnaires, words-descriptors, phrases-descriptors and other auxiliary verbal techniques for accurate diagnosis.