The specific headache phenotype, the accompanying symptoms and the psychological effects that lead to inpatient admission of patients with cluster headache are not yet known. The aim of this study from the Pain Clinic Kiel was therefore to analyze the characteristics of patients who were instructed in our tertiary headache center in 2018, 2019 and 2020 due to cluster headaches.

A total of 207 patients with cluster headache were examined who were recorded in 2018, 2019 and 2020. A retrospective cohort study was carried out to standardize the phenotype and the psychosocial effects of cluster headache. The data was collected on the basis of the standardized Kiel headache questionnaire, Migraine Disability Assessment (MIDAS) questionnaire and the World Health Organization (WHO) Disability Assessment Schedule (Whodas 2.0).

Most patients had a long -term chronic course of the disease, and 71.5 % had had the disease for more than 5 years. Cluster headache attacks occurred in 98.6 % of patients with strong to very strong pain intensity and more than 78 % of the patients experienced three or more attacks a day. The nightly attacks led to severe sleep disorders with exhaustion, lack of energy and incapacity to work. In 31.4 % of the patients, persistent permanent pain in this area also contributed to incapacity to work. A total of 94.7 % of the patients had a MIDAS score of grade 4 according to a very strong disability. The analysis of the WHODAS 2.0 scores showed that 92.7 % of the patients with cluster headaches were severely restricted in their health and functionality. These patients were particularly affected by the psychological accompanying symptoms and the psychosocial effects of cluster headache. The highly stressful complications of the cluster headache showed themselves particularly in the high frequency of suicidal thoughts in more than 40 % of the patients examined. The serious illness impaired almost all areas of professional, social and family life and caused a very high level of suffering.

The results show a pronounced, severe complex of symptoms in patients with cluster headache who goes far beyond the purely diagnostic criteria. The psychosocial effects of cluster headaches should be taken into account in the care of these patients.

Source:

Göbel Ch, Koch B, Heinze-Kuhn K, Heinze A, Cirkel A, Göbel H. Headache Phenotype and the Psychosocial Burden of Cluster Headaches: Analysis of Patients Prior to Hospitalization. Pain Ther. 2025 Feb 24. DOI: 10.1007/S40122-025-00715-9. Epub Ahead of Print. PMID: 39994092.

https://link.springer.com/article/10.1007/S40122-025-00715-9