In contrast to migraine and tension-type headache, psychological assessments of patients with cluster headache have been conducted to a very limited extent. Already in the earlier headache literature, the patient with cluster headache is characterized by a dissonance between the roughly structured physical stature and the great psychological insecurity :
Coarse facial structure with large acreas, deeply modulated facial structures, thick orange peel-like skin, coarse bone structures, broad shoulders and chunky extremities:. This “hypermasculine stature” is counteracted by psychological insecurity and anxiety.
According to headache pioneer Graham, the typical cluster headache patient comes accompanied by his wife . He should dependent and in need of support . Graham described this dissonance between physical stature and psychological characterization as the “ lion-mouse syndrome .” However, such a characterization was far from experimentally confirmed , but it does reflect the clinical impression of the time.
It was only in later years that standardized personality tests carried out on cluster headache patients. There were tendencies towards increased conscientiousness , complacency , increased need for control and tension . The Minnesota Multiphasic Personality Inventory ( MMPI ) found a tendency toward increased hypochondria and hysteria . not meaningful for methodological reasons . Overall, the current data does not allow any conclusions to be drawn regarding a specific personality profile in cluster headache patients. Restraint must also be exercised when dealing with the lion-mouse syndrome. The unpredictability and severity of the pain leave patients extremely disabled. Many people don't know when the next attack will occur. It would be extremely unusual if these patients had completely normal experiences and behavior