Major life changes may play a role in as many as a quarter of chronic daily headache cases that arise among otherwise healthy adult men and women, study findings suggest.

“Major life events may precipitate or co-occur with the development of chronic daily headaches,” Dr. Ann I. Scher said.

Scher, of Uniformed Services University, in Bethesda, Maryland, and colleagues assessed reports of major life changes among 206 men and women who met criteria for chronic daily headache (180 or more headache days per year). They assessed similar reports from 507 men and women with “episodic” headache (2 to 104 headache days per year).

The investigators assessed changes in work, marital status, children’s status, or residence; as well as deaths of family or close friends. They also inquired about self-defined “extremely stressful situations,” such as financial problems, an ongoing individual illness or that of a family member, or an ongoing abusive relationship.

Compared with men and women with episodic headache, men and women with chronic daily headache were more likely to have experienced major life events in the 2-year period prior to the onset of their headache condition, the researchers report in the medical journal Cephalalgia.

The strongest predictor of chronic daily headache was an ongoing extremely stressful situation.

The researchers also noted a higher proportion of chronic daily headache among people 40 years and older.

In this group, “a change in work status was related to increased risk for chronic daily headache, while in contrast, those younger than 40 years showed a decreased risk for chronic daily headache after a job change,” Scher told Reuters Health.

These findings are generally consistent with prior research related to other chronic pain conditions, the investigators note.

“Our finding that the relationship may be stronger for those older than 40 was an interesting, but secondary, finding that should be replicated in other samples,” Scher said.

SOURCE: Cephalalgia, August 2008