Validity and Reliability of Persian Version of Henry Ford Hospital Headache Disability Inventory Questionnaire

Background: A limited number of headache disability indices exist that can evaluate and manage different disabilities related to headache among Iranian patients. Objective: This study aimed to translate and validate the Persian version of the Henry Ford headache disability inventory (HDI). Methods: The original questionnaire was translated and culturally adapted to the Persian setting. A total of 250 patients with chronic headache were enrolled in this study. The questionnaire’s face validity, content validity, and convergent validity with Short-Form Health Survey (SF-36) were evaluated and a confirmatory factor analysis (CFA) was conducted. Its internal consistency was also assessed and its short- and long-term test-retest reliability were examined by intraclass correlation coefficient (ICC). Results: The content validity indices were 0.85, 0.99, and 0.97 for simplicity, relevance, and clarity, respectively. The content validity ratio was calculated as one for all items. The findings of CFA confirmed that this index had a good fit. Cronbach’s alpha was 0.91, 0.82, and 0.86 for the entire questionnaire as well as its functional and emotional subscales, respectively. The ICC was also calculated as 0.97 for the total inventory. The convergent validity showed significant negative correlations between HDI and short-form health survey items. Conclusion: The validity and reliability of the Persian version of the HDI were confirmed. This questionnaire can explore the disabilities of Persian-speaking people with headache disorders.

Response to Mindfulness-Based Cognitive Therapy Differs Between Chronic and Episodic Migraine

Objective:Evaluate whether the benefits of Mindfulness-Based Cognitive Therapy for Migraine (MBCT-M) on headache disability differs among people with episodic and chronic migraine.Methods:This is a planned secondary analysis of a randomized clinical trial. After a 30-day baseline, participants were stratified by episodic (6-14 days/month) and chronic migraine (15-30 days/month) and randomized to 8 weekly individual sessions of MBCT-M or wait list/treatment as usual (WL/TAU). Primary outcomes [Headache Disability Inventory; Severe Migraine Disability Assessment Scale (scores ≥ 21)] were assessed at Months 0, 1, 2, and 4. Mixed models for repeated measures tested moderation with fixed effects of treatment, time, chronic migraine and all interactions. Planned subgroup analyses evaluated treatment*time in episodic and chronic migraine.Results:Of 60 participants (MBCT-M N = 31, WL/TAU N = 29), 52% had CM. CM moderated the effect of MBCT-M on Severe Migraine Disability Assessment Scale, F(3, 205) = 3.68, p = .013; MBCT-M vs. WL/TAU reduced the proportion of people reporting severe disability to a greater extent among people with EM (-40.0% vs. -14.3%) than CM (-16.4% vs. +8.7%). Subgroup analysis revealed MBCT-M (vs WL/TAU) significantly reduced Headache Disability Inventory for episodic (p = .011) but not chronic migraine (p = .268).Conclusions:MBCT-M is a promising treatment for reducing headache-related disability, with greater benefits in episodic than chronic migraine.Classification of EvidenceThis study provides Class III evidence that MBCT-M reduces headache disability to a greater extent in people with episodic than chronic migraine. NCT02443519.

Brazilian Portuguese version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability

Background The Headache Disability Inventory assesses the dimensions of headache disability, but it is not available in Brazilian Portuguese yet. We aimed to translate the Headache Disability Inventory into Brazilian Portuguese and analyze its measurement properties. Methods Consecutive patients with headaches diagnosed by expert neurologists as per the International Classification of Headache Disorders were included. For the cross-cultural adaptation, 30 individuals answered the translated Headache Disability Inventory version. The internal consistency was evaluated, and the structural validity was assessed through exploratory factor analysis. For the construct validity assessment, 132 individuals answered the Headache Disability Inventory-Brazil, 12-item Short Form Survey (SF-12), and Headache Impact Test (HIT-6). After 1–3 weeks, 67 individuals again answered the Headache Disability Inventory-Brazil for the reliability assessment. The Pearson's correlation test, the intraclass correlation coefficient and the standard error of measurement were analyzed. Results The pre-stage version of the questionnaire was considered as the final version. The Headache Disability Inventory-Brazil had an internal consistency of 0.84 and consisted of a functional, emotional and social participation domain (factor loads > 0.3). The internal consistency ranged from 0.81 to 0.93 for each of the three domains. For the construct validity, the Headache Disability Inventory-Brazil presented moderate correlation with the SF-12 (r = −0.70, p < 0.05) and with the HIT-6 (r = 0.67, p ≤ 0.05). Its test-retest reliability was considered to be excellent (intraclass correlation coefficient = 0.95) and the standard error of measurement was 2.26 points. Conclusion The Headache Disability Inventory-Brazil was successfully translated and culturally adapted to the Brazilian population. It can be used for the impact assessment of primary and secondary headaches with validity and reliability equivalent to its original version.

Impairment in episodic and chronic cluster headache

Despite being an excruciating headache, little is known about the burden of cluster headache (CH) regarding its various subtypes. In a multicentre, prospective study, patients with chronic CH ( n = 27), with episodic CH in the active ( n = 26) and outside the active period ( n = 22), migraine patients ( n = 24) and healthy controls ( n = 31) were included. Epidemiological data, the German version of the Headache Disability Inventory (HDI) and a screening for psychiatric complaints were applied. About 25% of chronic CH patients in our study received invalidity allowance due to CH. HDI scores (total and subscales emotion and function) indicated a severe headache-specific disability (one-way ANOVA: P < 0.01). Patients with chronic and active episodic CH were significantly more affected than patients with inactive CH and migraine. Healthy volunteers were significantly less affected than all headache patients. Symptoms suggestive of psychiatric co-morbidity were found predominantly in chronic CH: depressive symptoms (56%), signs of agoraphobia (33%) and suicidal tendencies (25%) were frequently reported. Patients with chronic and active episodic CH were severely impaired in non-economic and economic domains such as disability, working life and psychiatric complaints. Remarkably, psychiatric co-morbidity was highest in chronic CH. Thus, especially chronic CH warrants special medical and further supportive care.

Psychosocial headache measures in Caucasian and African American headache patients: Psychometric attributes and measurement invariance

Introduction: As research increasingly examines differences in headache characteristics between Caucasian and African American headache patients, it is requisite to determine the equivalence of existing headache measures for both racial groups. Methods: This study examined the psychometric properties and measurement invariance of four widely used psychosocial headache measures. Caucasians ( N = 173) and African Americans ( N = 114) receiving treatment in four headache subspecialty clinics throughout Ohio completed the Headache Disability Inventory (HDI), the Migraine-Specific Quality of Life (MSQL) measure, the Headache Management Self-Efficacy (HMSE) scale, and the Headache-Specific Locus of Control (HSLC) scale prior to initiating new preventive therapies. Conclusion: All measures demonstrated good internal consistency and measurement invariance. Despite adequate measurement invariance, the recommended factor structure of the HMSE scale yielded a poor fit for both African American and Caucasian patients. With perhaps the exception of the HMSE scale, the HDI, MSQL scale and HSLC scale are psychometrically sound and can be used with both Caucasian and African American headache patients.