Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance

Lake, Alvin E.; Rains, Jeanetta; Penzien, Donald

doi:10.1111/j.1526-4610.2005.05101.x

Cited by 125 publications

(140 citation statements)

References 67 publications

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“…When compared to those with nonheadache, migraineurs are between 4 and 5 times more likely to suffer from major depression, dysthymia, and bipolar disorders; 3 to 10 times more likely to suffer from panic disorder (PD); 4 to 5 times more likely to suffer from generalized anxiety disorder (GAD); and 5 times more likely to suffer from obsessive-compulsive disorder (OCD). 1,2 Even when controlling for depression, migraineurs attempt suicide at a higher rate than individuals without migraine. 1 Migraineurs are also twice as likely to suffer from illicit drug abuse/dependence, alcohol abuse/dependence, and nicotine dependence.…”

Section: Why Screen For Psychiatric Disorders?mentioning

confidence: 99%

“…1 Migraineurs are also twice as likely to suffer from illicit drug abuse/dependence, alcohol abuse/dependence, and nicotine dependence. 1,2 The lifetime prevalence rates of various psychiatric disorders among migraine patients are as follows: major depression (34%), dysthymia (9%), bipolar II (4%), PD (11%), GAD (10%), OCD (9%), and phobias (40%). 3 Increased rates of psychiatric disorders have been observed in individuals suffering from chronic tensiontype headache as well.…”

Section: Why Screen For Psychiatric Disorders?mentioning

confidence: 99%

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A Review of Screening Tools for Psychiatric Comorbidity in Headache Patients

Maizels

Smitherman²,

Penzien³

2006

Headache

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Psychiatric comorbidity, especially depression and anxiety, has been well documented in patients with primary headache disorders. The presence of psychiatric comorbidity in headache patients is associated with decreased quality-of-life, poorer prognosis, chronification of disease, poorer response to treatment, and increased medical costs. Despite the prevalence and impact, screening for psychiatric disorders in headache patients is not systematically performed, either clinically or in research studies, and there are no guidelines to suggest which patients should be screened or in what manner. We review a variety of screening methods and instruments, focusing primarily on self-report measures and those available in the public domain. Informal verbal screening may be sufficient in a primary care setting, but should include screening for both anxiety and depression. Explicit screening for anxiety is important, as anxiety may have a more significant impact on headache than does depression and may occur in the absence of clinical depression. Formal screening with instruments that can identify a variety of psychiatric disorders is appropriate for patients with daily headache syndromes, patients who are refractory to usual care, and patients referred for specialty evaluation. Limitations of screening instruments include the influence of transdiagnostic symptoms and the need for confirmatory diagnostic interview. The following instruments appear most suitable for use in headache patients: for depression,

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Section: Why Screen For Psychiatric Disorders?mentioning

confidence: 99%

Section: Why Screen For Psychiatric Disorders?mentioning

confidence: 99%

A Review of Screening Tools for Psychiatric Comorbidity in Headache Patients

Maizels

Smitherman²,

Penzien³

2006

Headache

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“…Patients with headache have significantly higher rates of psychiatric comorbidity (4). Stress and anxiety are also the most frequent triggers of headaches (5).…”

Section: Introductionmentioning

confidence: 99%

Coping Strategies and personality traits in women patients with migraine and tension type headache

Özdemir¹,

Aykan²,

Özdemir³

2014

JMOOD

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Migren ve gerilim tipi başağrısı olan bayan hastalarda kişilik özellikleri ve baş etme yöntemleri Amaç: Stres ve anksiyete baş ağrılarının en sık tetikleyicileridir. Kişilik özellikleri ve başa çıkma yöntemleri bireylerin strese verdiği yanıtı etkiler. Yapılan çalışmalarda kaygılı ve depresif kişilik özelliklerinin başağrısına yatkınlık oluşturabileceğini, başağrısı olan hastaların işlevsel olmayan başa çıkma yöntemlerini daha sık kullandıklarını göstermiştir. Bu çalışmada migren ve gerilim tipi başağrısı olan bayan hastalarda başa çıkma yöntemlerinin ve kişilik özelliklerinin incelenmesini amaçlamıştır. Yöntem: Çalışmaya 45 migren, 45 gerilim tipi baş ağrısı olmak üzere toplam 90 hasta ve 42 sağlıklı gönüllü alınmıştır. Katılımcılara Görsel Analog Skala, Başa Çıkma Tutumlarını Değerlendirme Ölçeği (COPE), Eysenck kişilik anket / Revize Kısaltılmış Formu, Beck Depresyon Ölçeğive Beck Anksiyete ölçeği uygulanmıştır. Bulgular: Migren ve gerilim tipi baş ağrısı olan hastalarda sağlıklı bireylere kıyasla anksiyete ve depresyon düzeylerinin daha yüksek olduğu bulundu. Ayrıca, bu hastaların kontrol grubuna göre daha yüksek nörotizm puanlarına sahip olduğu tespit edildi. Migren hastalarında COPE alt ölçeklerinden yararlı sosyal destek kullanımı puanlarının kontrol grubuna kıyasla daha düşük, dini olarak başa çıkma düzeylerinin daha yüksek olduğu bulundu. Gerilim tipi baş ağrısı olan hastalarda ise aktif başa çıkma puanlarının kontrol grubuna göre daha düşük olduğu bulundu. Sonuç: Bu sonuçlar migren ve gerilim tipi baş ağrısı olan hastaların sağlıklı bireylerle karşılaştırıldığında aktif başa çıkma yöntemleri daha az kullandıklarını, daha fazla nevrotik kişilik özelliklerine sahip olduklarını, ayrıca daha yüksek depresyon ve anksiyete düzeylerine sahip olduklarını göstermektedir. Sözkonusu etkenler başağrılarının başlamasında, tetiklenmesinde ve şiddetinde önem taşıyabilir.

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“…In keeping with recent recommendation for research in headache and psychiatric comorbidity, 19 we used ICHD-II diagnostic headache criteria and reliable, validated questionnaires with clinically relevant cut-off scores to classify headache-related disability (Headache Impact Test [HIT-6]), 20 depression (Patient Health Questionnaire [PHQ]-9), 21 and somatic symptoms severity (PHQ-15). 22 HIT-6.…”

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confidence: 99%

Swiss cheese brain

Cochrane

Nguyen²

2007

Neurology

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Abstract-Objective:To better define, in women with headache, the relationship of depression and somatic symptoms to headache, characterized by diagnoses, frequency, and disability. Methods: At six headache specialty clinics, women with headache were classified using ICHD-II criteria, and frequency was recorded. A questionnaire addressing demographics, age at onset of headache, headache-related disability, somatic symptom, and depression severity was completed. Logistic regression was performed to measure the associations of headache frequency and headache-related disability with somatic symptom and depression severity. Results: A total of 1,032 women with headache completed the survey, 593 with episodic (96% with migraine) and 439 with chronic headache (87% with migraine). Low education and household income was more common in chronic headache sufferers and in persons with severe headache disability. Somatic symptom prevalence and severity was greater in persons with chronic headache and with severe headache-related disability. Significant correlation was observed between PHQ-9 and PHQ-15 scores (r ϭ 0.62). Chronic headache, severe disability, and high somatic symptom severity were associated with major depressive disorder (OR ϭ 25.1, 95% CI: 10.9 to 57.9), and this relationship was stronger in the subgroup with a diagnosis of migraine (OR ϭ 31.8, 95% CI: 12.9 to 78.5). Conclusions: High somatic symptom severity is prevalent in women with chronic and severely disabling headaches. Synergistic relationship to major depression exists for high somatic symptom severity, chronic headache, and disabling headache, suggesting a psychobiological underpinning of these associations.

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Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance

Cited by 125 publications

References 67 publications

A Review of Screening Tools for Psychiatric Comorbidity in Headache Patients

A Review of Screening Tools for Psychiatric Comorbidity in Headache Patients

Coping Strategies and personality traits in women patients with migraine and tension type headache

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