Zusammenfassung
Seit über 50 Jahren werden widersprüchliche Befunde zur Migränepersönlichkeit publiziert. Eine Literaturübersicht legt die Hypothese eines sekundären Neurotizismus nahe. Die Auslösung des akuten Migräneanfalls durch Stress konnte wiederholt gezeigt werden. Entsprechend beschäftigen sich neuere Studien mit spezifischen Belastungssituationen und Stressbewältigungsmechanismen von Migränepatienten. Es werden fünf Kritikpunkte zur Erklärung der insgesamt widersprüchlichen Befundlage dargelegt: 1. Da es sich bisher überwiegend um Querschnittsstudien handelt, kann die gefundene Persönlichkeitskonstellation nicht als prädisponierend angesehen werden. 2. Eine Differenzierung zwischen Kranken und Patienten findet häufig nicht statt; es kann aber nicht von Patienten, die den Arzt aufsuchen, auf alle Migränekranken generalisiert werden. 3. Von Migränespezifität sollte nur gesprochen werden, wenn sich die Migräniker nicht nur von Gesunden, sondern auch von anderen Kopfschmerzpatienten unterscheiden. 4. Viele Studien zur Migränepersönlichkeit unterscheiden nicht zwischen Untergruppen von Migränepatienten und 5. berücksichtigen nicht den periodischen Verlauf der Erkrankung. Zukünftige Studien sollten diese Desiderate miteinbeziehen.
Abstract
There have been conflicting reports on the relationship between migraine and personality for more than 50 years. Our review of the literature on migraine and personality supports the hypothesis of secondary neuroticism. Stress has repeatedly been shown to trigger acute migraine attacks. So recent studies focus on specific stressful situations and coping strategies in patients with migraine. In the present paper we discuss five issues that may explain the conflicting findings: 1. Because almost all of the studies have been cross-sectional, the personality constellations found in the patients with migraine cannot be regarded as predisposing factors. 2. Frequently no differentiation is made between migraineurs in general and those who are patients, but a generalization cannot be made from those who see a physician to all migraineurs. 3. The term „specific to migraine” is appropriate only if patients with migraine differ not only from healthy control subjects but also from patients with other types of headache. 4. Most studies on migraine personality do not differentiate between subgroups and 5. do not take into account the periodical course of the illness. Future studies should consider these findings.
Key words
Migraine - personality - neuroticism - coping mechanisms - review
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PD Dr. med. Dr. phil. Dorothea Huber
Institut und Poliklinik für Psychosomatische Medizin, Psychotherapie und Medizinische Psychologie · Klinikum rechts der Isar der TU München
Langerstraße 3
81675 München
Email: D.Huber@lrz.tum.de