Headache and anxiety/mood disorders: are we trapped in a cul-de-sac?

Galli, Federica

doi:10.1186/s10194-016-0710-1

Cited by 12 publications

(10 citation statements)

References 6 publications

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“…We are aware that co-occurring psychiatric disorders could complicate both headache and medication overuse behaviors. However, we believe that, while the strong comorbid association between depression/anxiety and chronic headache is well-known, it is important to focus on additional psychological components, such as child trauma and recent life events (Galli, 2017 ), that may explain why some patients with migraine evolve into CM+MOH. We assessed childhood trauma and current stressors using retrospective self-report questionnaires and without addressing the duration of such exposure.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic Experiences, Stressful Events, and Alexithymia in Chronic Migraine With Medication Overuse

Bottiroli¹,

Galli

Viana³

et al. 2018

Front. Psychol.

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Background: Many factors are involved in the prognosis and outcome of Chronic Migraine and Medication Overuse Headache (CM+MOH), and their understanding is a topic of interest. It is well known that CM+MOH patients experience increased psychiatric comorbidity, such as anxiety, depression, or personality disorders. Other psychological factors still need to be explored. The present study is aimed to evaluate whether early life traumatic experiences, stressful life events, and alexithymia can be associated with CM+MOH.Methods: Three hundred and thirty-one individuals were recruited for this study. They belonged to one of the two following groups: CM+MOH (N = 179; 79% females, Age: 45.2 ± 9.8) and episodic migraine (EM) (N = 152; 81% females; Age: 40.7 ± 11.0). Diagnosis was operationally defined according to the International Classification of Headache Disorders 3rd edition (ICHD-IIIβ). Data on early life (physical and emotional) traumatic experiences, recent stressful events and alexithymia were collected by means of the Childhood Trauma Questionnaire, the Stressful life-events Questionnaire, and the Toronto Alexithymia Scale (TAS-20), respectively.Results: Data showed a higher prevalence of emotional (χ2 = 6.99; d.f. = 1; p = 0.006) and physical (χ2 = 6.18; d.f. = 1; p = 0.009) childhood trauma and of current stressful events of important impact (χ2 = 4.42; d.f. = 1; p = 0.025) in CM+MOH patients than in EM ones. CM+MOH patients were characterized by higher difficulties in a specific alexithymic trait (Factor 1 subscale of TAS-20) [F(1, 326) = 6.76, p = 0.01, ηp2 = 0.02] when compared to the EM group. The role of these factors was confirmed in a multivariate analysis, which showed an association of CM+MOH with emotional (OR 2.655; 95% CI 1.153–6.115, p = 0.022) or physical trauma (OR 2.763; 95% CI 1.322–5.771, p = 0.007), and a high score at the Factor 1 (OR 1.039; 95% CI 1.002–1.078, p = 0.040).Conclusions: Our findings demonstrated a clear relationship between CM+MOH and life traumas, stressful events, and alexithymia. These observations have a relevant role in multiple fields of related to chronic headache: from the management to the nosographic framing.

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Section: Discussionmentioning

confidence: 99%

“…Since 1990 (Merikangas et al, 1990 ), the association of psychiatric disorders and headache has been labeled as comorbidity. Defining the factors that are involved in the association headache with psychiatric comorbidity is compelling and helpful to overcome the cul de sac of a long-lasting inexplicable association (Galli, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Traumatic Experiences, Stressful Events, and Alexithymia in Chronic Migraine With Medication Overuse

Bottiroli¹,

Galli

Viana³

et al. 2018

Front. Psychol.

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“…Two reviews analysed the link of AF with anxiety and depression ( McCabe, 2010 ; Patel et al, 2013 ) suggesting a condition of comorbidity. However, the comorbidity of anxiety and depression is common in so many and different disorders and diseases ( American Psychiatric Association, 2013 ; Galli et al, 2017 ; Galli, 2017 ) that we need to enlarge our perspective. Temperament, adverse childhood experience, stressful life events and personality are well known psychological mechanisms representing risk and prognostic factors for anxiety and mood disorders, ( American Psychiatric Association, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Atrial fibrillation and psychological factors: a systematic review

Galli

Borghi

Carugo

et al. 2017

PeerJ

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BackgroundPsychological factors have been suggested to have an influence in Atrial Fibrillation (AF) onset, progression, severity and outcomes, but their role is unclear and mainly focused on anxiety and depression.MethodsA systematic electronic search had been conducted to identify studies exploring different psychological factors in AF. The search retrieved 832 articles that were reviewed according to inclusion criteria: observational study with a control/comparison group; use of standardized and validated instruments for psychological assessment. Results were summarized qualitatively and quantitatively by effect size measure (Cohen’s d and its 95% confidence interval). Cochrane Collaboration guidelines and the PRISMA Statement were adopted.ResultsEight studies were included in the systematic review. Depression was the most studied construct/ but only one study showed a clear link with AF. The remaining studies showed small and non-significant (95% CI [−0.25–1.00]) differences between AF and controls, no differences in frequency of depression history (95% CI [−0.14–0.22]) or in case frequency (95% CI [−0.50–0.04]). Miscellaneous results were found as far as anxiety: AF patients showed higher levels when compared to healthy subjects (95% CI [2.05–2.95]), but findings were inconsistent when compared to other heart diseases. Considering personality and life-events preceding AF, we respectively found a large (95% CI [1.87–2.49]) and a moderate to large effect (95% CI [0.48–0.98]).DiscussionThe small number of studies does not allow to draw clear-cut conclusions on the involvement of psychological factors in AF. Promising lines of research are related to personality and adverse life-events, and to the increase of longitudinal design studies. Some methodological problems could be overcome by including clinical psychologists in the implementation of research protocols.

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“…Based on previous studies, mood disorders and cognitive impairments could impact the structural[ 9 ] and functional changes[ 39 40 41 ] in the cerebrum in MOH. However, the psychological scale did not relate to the brainstem volume in the MOH patients in the current study.…”

Section: Discussionmentioning

confidence: 99%

Volume Gain of Brainstem on Medication-Overuse Headache Using Voxel-Based Morphometry

Chen

Liu

et al. 2018

Chinese Medical Journal

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Background:Histopathology identified the anatomical and molecular abnormalities of brainstem nuclei in migraine patients. However, the exact whole brainstem structural changes in vivo have not yet been identified in medication-overuse headache (MOH) transformed from migraine. The aim of this study was to investigate the regional volume changes over the whole brainstem in the MOH patients using voxel-based morphometry (VBM) in vivo.Methods:High-resolution three-dimensional structural images were obtained using a 3.0-Tesla magnetic resonance system from 36 MOH patients and 32 normal controls (NCs) who were consecutively recruited from the International Headache Center, Chinese People's Liberation Army General Hospital, from March 2013 to June 2016. VBM was used to assess the brainstem structural alteration in the MOH patients, and voxel-wise correlation was performed to evaluate the relationship with the clinical characteristics.Results:The brainstem region with increased volume located in the left ventrolateral periaqueductal gray (MNI coordinate: -1, -33, -8), ventral tegmental area (MNI coordinate: 0, -22, -12), bilateral substantia nigra (MNI coordinate: -8, -16, -12, 9, -16, -12), and trigeminal root entry zone (MNI coordinate: -19, -29, -31; 19, -32, -29) in MOH patients compared with NCs. The headache visual analog scale score was positively related with the left rostral ventromedial medulla (RVM) (MNI coordinate: -1, -37, -56; cluster size: 20; r = 0.602) in the MOH patients.Conclusions:The regional volume gain of brainstem could underlie the neuromechanism of impaired ascending and descending pathway in the MOH patients, and the left RVM volume alteration could imply the impaired tolerance of nociceptive pain input and could be used to assess the headache disability in the MOH patients.

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Headache and anxiety/mood disorders: are we trapped in a cul-de-sac?

Cited by 12 publications

References 6 publications

Traumatic Experiences, Stressful Events, and Alexithymia in Chronic Migraine With Medication Overuse

Traumatic Experiences, Stressful Events, and Alexithymia in Chronic Migraine With Medication Overuse

Atrial fibrillation and psychological factors: a systematic review

Volume Gain of Brainstem on Medication-Overuse Headache Using Voxel-Based Morphometry

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