In contrast to migraine and tension-type headache, psychological studies conducted on patients with cluster headache only to a very limited extent. Even in earlier headache literature, the patient with cluster headache is characterized by a dissonance between their robust physical physique and their profound psychological insecurity .
A coarse facial structure with large extremities, deeply sculpted facial features, thick, orange-peel-like skin, coarse bone structure, broad shoulders, and chunky extremities: This "hypermasculine physique" is counteracted by psychological insecurity and anxiety.
According to headache pioneer Graham, the typical cluster headache patient therefore arrives at accompanied by his wife . He is said to dependent and in need of support . Graham described this dissonance between physical stature and psychological character as the " lion-mouse syndrome ." However, such a characterization was far from being experimentally confirmed ; nevertheless, it reflects the clinical impression of the time.
Only in later years were standardized personality assessments conducted on cluster headache patients. These revealed tendencies toward increased conscientiousness , self-satisfaction , a heightened need for control, and tension . The Minnesota Multiphasic Personality Inventory ( MMPI ) showed a tendency toward increased hypochondria and hysteria not methodologically . Overall, the current data does not allow for any conclusions regarding a specific personality profile in cluster headache patients. Caution is also advised regarding the "lion-mouse syndrome." Due to the unpredictability and severity of the pain, patients are extremely debilitated. Many do not know when the next attack will occur. It would be exceptionally unusual for these patients completely normal experiences and behavior .