Chronic Pain

Sex and age characteristics of pain perception

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Lukina E.V., Rusanova A.M.

Purpose: To evaluate the profile (types, course features, concomitant manifestations, correlation with other factors) of headache in full-time young students.
Under supervision were 150 respondents from 16 to 25 years old, studying full-time. Our respondents did not have gross organic neurological, somatic disorders, and were not observed with the relevant specialists.

Among students, the majority of respondents experience headache (GB) at least once a month or more, but only 38% of them complained of GB, which indicates a subjective perception of this disease and adds additional complexity to its analysis and assessment. Provocateurs GB is mental stress, stress, physical activity. To combat GB, many young people take pain medications, thereby not affecting the RF.

Comorbid accompaniment significantly complicates the diagnosis of GB and treatment tactics, which is especially evident in middle and old age. Many measures aimed at eliminating risk factors are not only not observed, but also do not seem necessary, as well as a high percentage of "self-medication", it is necessary to conduct extensive educational and preventive work with these population groups.

Keywords

According to the WHO, headache is one of the most common complaints in general medical practice. 47% of the world's adult population suffers from a headache that occurs at least once a month. The most common headache variants, such as migraine, tension headache, cluster headache, chronic daily headache syndrome, can lead to a significant decrease in the quality of life. In addition, a headache can be a symptom of many organic neurological, somatic, psychogenic diseases. Over the past ten years, science has made a significant breakthrough in understanding the etiopathogenetic factors of cephalgia. And currently there are quite effective types of treatment for many types of headaches. However, only a very small proportion of people suffering from this ailment around the world receive a complete diagnosis and timely treatment of cephalgia. It is for this purpose that the ICGB exists, which is undergoing constant review to clarify the correct etiopathogenetic approach to this serious problem. In addition, headache has its own characteristics depending on age, gender, lifestyle, and concomitant pathology. Therefore, an important task of the doctor is to identify risk groups among the young population, conducting active preventive activities, as well as timely diagnosis and adequate treatment of headaches.

Purpose of work: To evaluate the headache profile (types, course features, concomitant manifestations, correlation with other factors) in young students in full-time study.

  • To assess the incidence of headache in full-time students of young people.
  • Identify the factors that provoke cephalgia in this category of patients.
  • To identify the symptoms associated with cephalgia and evaluate its relationship with the nature of the headache.
  • To establish what basic methods of dealing with headache are used among students of a young age, the willingness of patients to preventive measures.
  • To assess the level of awareness of young learners about risk factors, methods of diagnosis and treatment of headaches.

Under our supervision, there were 150 respondents aged 16 to 25 years studying in full-time in schools, colleges and universities. Our respondents considered themselves to be quite healthy, i.e. did not have gross organic neurological, somatic disorders and were not observed with the relevant specialists.

An original questionnaire was created, consisting of 45 questions, which included the following sections

  • General information
  • Questions about the individual character, frequency of occurrence, accompanying headache
  • Questions about the concept of healthy lifestyle and health among our respondents
  • Self-assessment of anxiety (Tsung scale)
  • Visual analog headache self-assessment scale

Among our respondents, 99 people (66%) were female, the remaining 51 people (34%) were male. Most respondents 90 people (60%) are students of schools and colleges, 42 people (28%) are full-time students of universities. During the day, all respondents study at educational institutions, and in the afternoon do their homework.
All of our respondents were divided into 2 groups, 1 group (58 people) consisted of respondents complaining of a headache, group 2 - 92 people - not complaining of a headache. Both groups corresponded to each other by gender and age. We compared the incidence of headaches in these groups depending on academic performance, level of anxiety, lifestyle, etc.

58 people (38%) of the total number of respondents complain of headaches. 50 (86%) of them suffer from headaches from several times a month to several times a week. More than half of the young people surveyed, namely 92 people (62%) consider themselves to be completely healthy and their headache does not bother them. However, only 22 of them (14%) experience headaches very rarely or not at all. The remaining 70 people (76%) still report a headache from several times a month to several times a week. But the question "do you suffer from a headache?" Give a negative answer. Thus, the headache bothers representatives of both groups approximately equally often, however, the subjective perception of this ailment is very different, which adds additional complexity to its analysis and assessment (Fig. 1). Moreover, 46 women (79%) and 12 people (21%) are male more often complain of headaches. In the 2nd group, headache was observed in 45 girls (49%), in 24 young men (26%). This is due to the greater emotional lability of the female representatives.
The average intensity of cephalgia in individuals complaining of a headache is 4.3 points, a maximum of 7.2 points on YOUR. Most often, it is accompanied by the flashing of “flies” in front of the eyes, darkening in the eyes, nausea, loss of appetite, less often - the appearance of sharp smells, sounds, abdominal pain or even vomiting, as well as other manifestations (Fig. 2).
Among those who do not complain of a headache, 55 people (60%) rate their health as “good”, 38% rate it satisfactory. Among those complaining of a headache, only 20% rate their health as good, and 14% rate their health as poor. (Fig. 3) This once again proves the subjectivity of headache perception.

According to the results of our survey, the most frequent provoking factor is just mental stress (in 60 respondents, 41%) and emotional stress (in 57 respondents, 39%), and physical activity plays a significant role (in 25 respondents, 18%). Among people complaining of a headache, almost half of the respondents have an average score of 4–4.5, (46%), three-way students and excellent students complain of a headache in approximately the same way. It should be noted that among people who do not complain of a headache, the percentage of academic performance is the same (Fig. 4). Therefore, we can conclude that there is no clear correlation between headache and academic performance in this category of patients. It is noteworthy that 43% of the respondents in the group complaining of headache have anxiety disorder, and 4% are of moderate severity. Among people who do not complain of a headache, mild anxiety disorder is observed two times less often (17%) than in group 1 (Fig. 5). The data obtained may indicate the presence of a clear relationship between the headache phenomenon and the disturbing personality traits.
Touching on the lifestyle of the respondents, a question was asked how often a phone / computer / tablet, TV is used in everyday life. Among the group of respondents who complain of a headache, 39 people - 75% are constantly in contact with electronic devices, in the second group - who do not complain of a headache, a slightly smaller number of respondents - 60 people, which is 64%, constantly makes contact with electronic devices, which amounted to 64% ( Fig. 6).
Those who have practically no contact with any devices, such 3 people (1%), have no complaints about a headache, and if it does occur, then its intensity averages 1 point according to YOUR and reaches a maximum of 3.5 points, which is lower than all others. (Fig. 7)
Currently, more than half of the respondents (85 people, 57%) do not watch TV or watch it for less than 1 hour per day. However, among those who constantly contact with electronic devices and watch TV for more than 3 hours a day (22 people, 14.6%), more than half (12 people) complain of a headache.
Thus, a pronounced dependence of headache on contact with gadgets has not been identified, but their effect on the occurrence and intensity of cephalgia cannot be completely ruled out. Despite the fact that in modern society it is not possible for young people who receive full-time education to completely exclude contact with gadgets, it is not only possible, but also necessary to regulate these relationships, the mode of work and outdoor activities. Which is far from always respected and recognized by young people.

Among our respondents, motion sickness in transport was noted by 72% (48 people) from group 1 (complaining of a headache), and 50% (45 people) from group 2 also noted the fact of motion sickness in the car. We conditionally divided all patients in each group by another 2, depending on the history of motion sickness in transport. It turned out 4 groups:

  • complaints of GB and motion sickness in transport history of 1A 72%
  • complaints of GB, no motion sickness in transport history of 1B 28%
  • no complaints about GB, motion sickness in transport history 2A 48%
  • there are complaints of headache, no motion sickness in transport 2B 52%

The respondents complaining of a headache and noting the fact of motion sickness in transport, subgroup 1A, significantly prevail over subgroup 1B. Almost all indicate mental or emotional stress as the cause of the headache in subgroup 1A. Respondents who were not sick of transport, but who complain of a headache (1B subgroup) indicate that their illness occurs in most cases spontaneously, without any connection with anything. The incidence and intensity of cephalgia are approximately the same in both subgroups 1A and 1B. Having examined those who do not complain of headaches, it was found that most nevertheless report cephalgia from several times a week to several times a month in both subgroups, between 2A and 2B there is no significant difference in the frequency of occurrence of headache, intensity, and provoking factors . Thus, there is a positive relationship between the anamnestic factor of motion sickness in transport and the frequency of headache complaints (however, it was difficult to establish its nature according to our survey). In persons who are not bothered by a headache, such a relationship is not visible.

To cope with a headache, the majority of respondents among all respondents (90 people, 60%) have enough rest, sleep. Also, to reduce headaches, the most popular answers are: compliance with the regime of work and rest, staying in the fresh air, regular exercise with moderate physical activity and constant rejection of bad habits. However, half of the respondents 76 people - 50.6% also take painkillers to eliminate headaches, and 26 people - 17% do this regularly. All respondents considered themselves to be completely healthy people and did not turn to specialists. From this it follows that the percentage of "self-treatment" of respondents is quite high.

  • Among young people studying, the vast majority of respondents experience headaches at least once a month or more, but only 38% of them complain of headaches, which indicates a subjective perception of this disease, which adds additional complexity to its analysis and assessment . In addition, cephalalgia is more common in women, which is associated with greater emotional lability of women.
  • The most common triggers for headaches are mental stress, stress, and physical activity.
  • Most often, headache in young students is accompanied by vegetative manifestations (darkening in the eyes, flickering "flies" in front of the eyes, the appearance of nausea, loss of appetite), less commonly, abdominal pain, vomiting, etc.
    There is no clear correlation between the frequency and intensity of headache and performance in young people.
    Most people complaining of a headache had a history of motion sickness in transport, so the presence of childhood paroxysmal disorders (in particular, motion sickness in transport) is one of the risk factors for headache.
  • To combat headaches, many young people go to bed, go out into the fresh air and use other non-medication. However, 50% of respondents take painkillers when a headache occurs, and 17% do it regularly, thereby not having any effect on risk factors, they are engaged in symptomatic self-medication.
  • More than half of the young population theoretically knows about risk factors, and also realizes the importance of maintaining a healthy lifestyle. But almost none of them is aware of the relationship of headaches with excessive use of electronic devices, no more than 30% of young people observe elements of a healthy lifestyle, a rational regime of the day, work and rest, but do not seek qualified medical help from specialists.

Since, comorbid accompaniment significantly complicates the diagnosis of headache and treatment tactics, which is especially evident in middle and old age, it is necessary to evaluate the nature of the headache, the nature of its course, the intensity, the presence of risk factors in young patients in order to correctly assess the nature cephalgia in their future and prevent a decline in the quality of life of patients. Given that many measures aimed at eliminating risk factors are not only not observed, but also do not seem necessary, as well as a high percentage of symptomatic “self-medication” and a lack of conscious awareness of the risk factors for headaches among the young population, it is necessary to conduct extensive educational and preventive work with these populations.

Literature

1) Stock V.N. Some comments on the revised version of the International Classification of Headache (ICGB-III, beta version, 2013) - Journal of Neurology and Psychiatry named after S. S. Korsakov, publishing house “Media Sphere”, No. 2.- P.87- 90, 2014

2) International Classification of Headaches (ICGB), version 3 beta, 2013, Lebedeva E.R., Osipova V.V., Tabeeva G.R., Olesen - Ural Medical Journal, publishing house “Ural State Medical University ”, No. 3 (117) .- P. 48-51, 2014

3) N.N. Zavadenko, Yu.E. Nesterovsky, G.Sh. Khondkaryan, E.M. Shipilova, A.A. Choline. Primary headaches in children and adolescents. - M: Antidor, 2015 - 89 s.

4) Lisitsyn Yu.P. Lifestyle as the basis of health. Analysis of risk factors for morbidity: a problematic article. / Yu.P. Lisitsyn. - Medical newspaper, No. 19 - P. 12. 2010

5) Scales, tests and questionnaires in medical rehabilitation: ed. A.N. Belova, O.N. Schepetova. - M: Antidor, 2002 - 440 p.

6) V.V. Osipova, G.R. Tabeeva. Primary headaches (a practical guide), - Medical News Agency, 2007- 142 p.

7) A.P. Rachin, T.G. Avdeeva, A.V. Sergeev. Headache in children (lecture for neurologists and pediatricians), - Medical News Agency, 2004 - 212.

8) Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition 2013. – International Headache Society, p. 180, 2013

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