Personality and Social Psychology Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches MEHMET ESKIN, 1 ALI AKYOL, 1 EMINE YILMAZ C ß ELIK 2 and B € ULENT KADRI G € ULTEKIN 3 1 Adnan Menderes University, Faculty of Medicine, Department of Psychiatry, Aydin, Turkey 2 Özel Torbalı Tıp Merkezi, Nöroloji Bölümü, Torbalı, _ Izmir, Turkey 3 Erenk€ oy Ruh ve Sinir Hastalıkları E gitim ve Aras ßtırma Hastanesi, Istanbul, Turkey Eskin, M., Akyol, A., C ß elik, E. Y. & G€ ultekin, B. K. (2013). Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches. Scandinavian Journal of Psychology 54, 337–343. This study aimed at investigating social problem solving, perceived stress, depression, and life-satisfaction in patients with tension type and migraine headaches. Forty-nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self-report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one’s life. T-tests, chi-square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of per- ceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life-satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life- satisfaction in patients suffering from primary headache. Key words: Social problem-solving, headache, perceived stress, depression, life-events, life-satisfaction. Mehmet Eskin, Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey. E-mails: meskin@adu.edu.tr or eskin_mehmet@yahoo.com.tr INTRODUCTION Headache is one of the most prevalent neurological disorders. The literature (Stovner, Hagen, Jensen et al., 2007) suggests that 46% of the adult population worldwide suffer from a headache disorder, 11% from migraine, 42% from tension-type headache and 3% from a chronic daily headache disorder. A recent review on the prevalence of headache in Europe showed that 50% of adult Europeans suffer from headaches, 60% suffer from tension type headaches while 15% suffer from migraine (Stovner & Andree, 2010). Studies show that headache is a frequent condi- tion in Turkish school children (Akyol, Kiylioglu, Aydin et al., 2007; € Ozge, Bugdayci, Sasmaz et al., 2002), university students (Demirkiran, Ellidokuz & Boluk, 2006; Kaynak-Key, Donmez & Tuzun, 2004; Kurt & Kaplan, 2007) and adults (C ß elik, Ekuklu, Tokuc ß & Utku, 2004). The two genders are affected by head- aches differently. The literature shows that the prevalence of headache disorders is higher in women than in men (Houinato, Adoukonou, Ntsiba, Adjien, Avode & Preux, 2010; Ojini, Okubadejo & Danesi, 2009; Russell, Kristiansen, Saltyte-Benth & Kvaerner, 2008; Steward, Wood, Reed, Roy & Lipton, 2008). Headache disorders constitute a significant burden for both the affected individual and society. It affects sufferers’ quality of life, participation in work and social activities (Stovner & Andree, 2008; Diener, Steiner & Tepper, 2006; € Uneri, S ßenbil, Turgut, 2009). The inflicted person may have difficulty in estab- lishing and maintaining social relationships which may result in lowered social support and self-esteem. Due to restrictive nature of the disorder headache sufferers can often not participate in the workforce and may need medical treatment. Thus, the headache disorders constitute a major burden to the national economy and health care systems. Scientific evidence shows that psychiatric co-morbidity is high in persons suffering from headache disorders (Filippis, Salvatori, Coloprisco & Martelletti, 2005; Kececi, Dener & Analan, 2003; Pompili, Cosimo, Innamorati, Lester, Tatarelli & Martelletti, 2009; € Oyekc ßin, Sarıkaya, Duraklı & Erol, 2007; Radat & Swendsen, 2004; Villani, Bruti, Mostardini et al., 2005). Depres- sion and anxiety are the two most common psychiatric diagnoses in headache patients. For instance, one study with 5,417 primary care migraine patients found that 67% were anxious and 59% were depressive (Radat, Mekies, Geraud et al., 2008). Research indicates that psychiatric co-morbidity is higher in tension type headache than in migraine patients. One study documented psy- chiatric co-morbidity (depression, anxiety) in 55.4% of the ten- sion type headache patients while the corresponding figure in migraine patients was 45.5% (Atasoy, Atasoy, € Unal, Konuk & Atik, 2004). Another study found out that the prevalence of any psychiatric co-morbidity (depression and anxiety) was 77.8% in tension type headache patients while it was 56.4% in migraine patients without aura (Puca, 2000). Although there is no general agreement on the relationship between personality and headache, some studies suggest that headache patients may share certain psychological features. For instance findings from one study suggest that avoidance, rigidity, being reserved and obsessivity characterize patients with © 2013 The Scandinavian Psychological Associations Scandinavian Journal of Psychology, 2013, 54, 337–343 DOI: 10.1111/sjop.12056