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Published on: February 2, 2017
Influence of psychological stress on headache in patients with systemic lupus erythematosus
José Antonio Vargas-Hitos1, José Mario Sabio, Isabel Martínez-Egea
1From the Systemic Autoimmune Diseases Unit, Internal Medicine Department, the Clinical Analysis Department, and the Department of Statistics, Virgen de las Nieves University Hospital; Occupational Medicine, MAZ Department, Granada; Internal Medicine Department, Asturias Central Hospital, Oviedo; Internal Medicine Department, Carlos Haya University Hospital, Málaga; Internal Medicine Department, San Cecilio University Hospital, Granada, Spain.
Objective:
To compare the prevalence and disability of headache in patients with systemic lupus erythematosus (SLE) with the general population and to assess the role of chronic psychological stress (CPS) in headache development.
Methods:
One hundred seventy patients with SLE and 102 control subjects matched for age, sex, and level of education were included in this multicenter, cross-sectional study. CPS, headache-related disability, and chronic analgesic intake (CAI) were evaluated in all participants.
Results:
No statistical differences in the prevalence of headache between both groups were observed but headache disability was significantly higher in patients with SLE. In addition, a higher average score in the Cohen Perceived Stress Scale (CPSS) and a higher prevalence of patients with CAI were observed in patients with SLE. In multivariate analysis, CPSS score was positively (OR 1.09; 95% CI: 1.03-1.14; p = 0.001) and CAI negatively (OR 0.43; 95% CI: 0.19-0.99; p = 0.049) associated with headache in patients with SLE.
Conclusion:
Despite the prevalence of headache in patients with SLE and the general population being similar, headache-related disability may be higher in patients with SLE. Moreover, CPS might play a role in the pathogenesis of SLE headache, whereas CAI might have a protective effect against it.
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