Stress and medicine use for headache: does sense of coherence modify the association?

BACKGROUND: Medicine use as a strategy for coping with daily stressors is an under-studied issue. Studies show that stress is associated with use of over-the-counter medicine, but the underlying mechanisms are not well understood. The aim of this study was to examine whether sense of coherence (SOC) modifies the association between perceived stress and medicine use for headache. METHODS: National cross-sectional study in Denmark. Study population: men and women aged 25-44 years, n = 990. The survey was conducted by web-based questionnaires and telephone interviews. The outcome measure was medicine use for headache. The independent variable was perceived stress. SOC and gender were investigated as moderators. Social class, headache prevalence and severity, and response method were included as co-variates. RESULTS: Our study showed that SOC modified the association between stress and medicine use for headache (only statistically significant among women). The odds for medicine use among women who felt stressed were 2.30 (1.39-3.79) compared to women who did not feel stressed; among men who felt stressed the equivalent odds were 1.46 (0.80-2.66). In analysis stratified by SOC, the odds for medicine use when stressed were 2.09 (0.71-6.21) among women with high SOC, 2.21 (1.10-4.41) among women with medium SOC and 3.69 (1.09-12.47) among women with low SOC. The equivalent odds for men were 1.29 (0.33-5.04), 1.33 (0.59-3.04) and 2.47 (0.57-10.64), respectively. CONCLUSION: SOC modifies the association between stress and medicine use especially among women. Individuals with fewer coping resources may be more likely to use medicine beyond indication to treat stress.