Positive results of M1 stimulation in other studies, and the absence of significant benefits of active high-frequency rTMS of the DLPFC in the present study, point to M1 as a more promising target than the DLPFC, for larger trials of noninvasive brain stimulation in patients with chronic migraine.
Psychiatric comorbidity, mainly anxiety and depression, are common in chronic migraine (CM). Phobias are reported by half of CM patients. Phobic avoidance associated with fear of headache or migraine attack has never been adequately described. We describe 12 migraine patients with particular phobic-avoidant behaviours related to their headache attacks, which we classified as a specific illness phobia, coined as cephalalgiaphobia. All patients were women, mean age 42, and all had a migraine diagnosis (11 CM, all overused acute medications). Patients had either a phobia of a headache attack during a pain-free state or a phobia of pain worsening during mild headache episodes. Patients overused acute medication as phobic avoidance. It is a significant problem, associated with distress and impairment, interfering with medical care.Cephalalgiaphobia is a possible specific phobia of illness, possibly linked to progression of migraine to CM and to acute medication overuse headache.
INTRODUCTION: Chronic migraine (CM) is a common medical condition affecting 2.4% of the general population. Depression is one of the most frequent comorbid disorders in CM. METHOD: Seventy patients diagnosed with chronic migraine were studied. All patients evaluated filled out the Beck Depression Inventory (BDI). Depression severity was divided into none or minimal depression, mild, moderate, and severe. RESULTS: BDI ranged from 4 to 55, mean 21 ± 10.7. Moderate or severe depression, were present in 58.7% of the patients . Some degree of depression appeared in 85.8% of patients. The BDI scores correlated with pain intensity (p = 0.02). Severe depression was more frequent in patients with comorbid fibromyalgia and in patients reporting fatigue. CONCLUSION: The BDI is an easy tool to access depression in CM patients. Suicide risk assessment is needed in CM patients. Patients with fibromyalgia and fatigue are at even higher risk for severe depression.
-B a c k g round: Comorbidity of chronic migraine (CM) with psychiatric disorders, mostly anxiety and mood disorders, is a well-recognized phenomenon. Phobias are one of the most common anxiety diso rders in the general population. Phobias are more common in migraineurs than non-migraineurs. The clinical profile of phobias in CM has never been studied. Method: We investigated the psychiatric profile in 56 patients with CM using the SCID I/P interview. Results: Lifetime criteria for at least one mental d i s o rder was found in 87.5% of the sample; 75% met criteria for at least one lifetime anxiety disorder and 60.7% of our sample fulfilled DSM-IV criteria for lifetime phobic avoidant disorders. Mood and anxiety s c o res were higher in phobic patients than in non-phobic CM controls. Number of phobias correlated with higher levels of anxiety and depre s s i o n . Conclusion: Phobias are common in CM. Its recognition may influence its management. Early treatment may lead to better prognosis.KEY WORDS: headache, migraine, anxiety, phobias. Fobias, outras comorbidades psiquiátricas e enxaqueca crônicaRESUMO -I n t rodução: As comorbidades psiquiátricas das enxaquecas crônicas são bem conhecidas. As fobias, transtorno ansioso mais comum, são mais prevalentes entre enxaquecosos do que entre não enxaquecosos. O perfil clínico de fobias em uma população enxaquecosa nunca foi estudado. M é t o d o : Estudamos aspectos psiquiátricos de uma população de 56 pacientes com enxaqueca crônica. R e s u l t a d o s :Usando o SCID I/P para o DSM-IV, critérios diagnósticos para ao menos algum transtorno psiquiátrico durante a vida foram preenchidos por 87,5% de nossa amostra, 75% para ao menos um transtorno ansioso e 60,7% para condições fóbicas em algum momento de suas vidas. Os escores de ansiedade e humor foram maiore s e n t re os fóbicos e o número de fobias teve correlação positiva com o grau de ansiedade e depre s s ã o . Conclusão: Fobias são comuns na enxaqueca crônica e seu reconhecimento poderia influenciar seu manejo e melhorar seu prognóstico.
Aims The aim of the present study was to evaluate the association between generalized anxiety disorder, subthreshold anxiety (SubAnx) and anxiety symptoms in the prevalence of primary headache. Methods This cross‐sectional study evaluated 383 people from a Brazilian low‐income community. One‐year prevalence rates of migraine, chronic migraine and tension‐type headache were calculated. Anxiety symptoms were then separated into the following groups (based on DSM‐IV criteria): no anxiety criteria; one anxiety criterion; two anxiety criteria; and generalized anxiety disorder (GAD). The control group (no headaches) was compared with headache sufferers for each anxiety group using an adjusted model controlled for confounding factors. Results GAD was present in 37.0% of participants and SubAnx in 16.6%. Those with SubAnx had a 2.28‐fold increased chance of having migraine; 3.83‐fold increased chance of having chronic migraine, a 5.94‐fold increased chance of having tension‐type headache and a 3.27‐fold increased chance of having overall headache. Some anxiety criteria (irritability, difficulty with sleep, concentration problems, muscle tension and fatigue) had similar prevalence to International Classification of Headache Disorders (ICHD‐II) headache criteria such as unilateral pain and nausea for migraine and chronic migraine. Conclusion Headache sufferers seem to have a high prevalence of anxiety symptoms and SubAnx. In addition, the presence of two or more anxiety criteria (not necessarily fulfilling all the criteria for GAD) was associated with having a headache disorder.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.