ИСТИНА

Introduction.– Differentiation of patients with primary and secondary to mental illness pain is an important diagnostic task of general clinics and emergency centers (Radat et al., 2011). Emotional and cognitive factors that predict avoidance behaviour and quality of life decline in patients with chronic pain (Smitherman et al., 2015, Norton, Asmundson, 2004) could possibly help for differentiation. Objectives.– The aim was to compare illness representation in patients with headache secondary to psychiatric disorders and other chronic headaches. Methods.– 30 patients with headache secondary to personality and affective disorders and 74 patients with chronic migraines and tension-type headaches filled Migraine Disability Assessment Test (Stewart, 2001), Cognitions About Body and Health Questionnaire (Rief et al., 1998), Illness Perception Questionnaire (Moss-Morris et al., 2002) and Quality of Life and Enjoyment Questionnaire (Ritsner et al., 2005), Morisky-Green Test (Morisky et al., 1986). Results.– Comparing to primary headaches, in patients with secondary pain intensity is more related to dissatisfaction with health and emotions (r =−.69; −.66 versus r =−.39; −.31). They almost never reported neutral relationship to headache from relatives (2 = 6.51, P < .05) but reported higher limitations in work, personal control of illness, more fears about diagnosis and better adherence (t =−2.56; −1.96, P < .05). Conclusions.– Higher sensitivity to pain intensity, feeling of control and adherence reported by patients with headaches if accompanied by fears about diagnosis, emotional reactions of relatives and limitations at work allow suspecting mental illnesses underlying chronic pain. Funding.– The reported study was funded by RFBR according to the research project no. 17-29-02169. Disclosure of interest.– The authors have not supplied a conflict of interest statement.