INTRODUCTIONHeadache occurs with number of psychiatric disorders, including depressive disorders, anxiety disorders, posttraumatic and stress-related disorder. There is always a common causative factors and reciprocal influence between headache and psychiatric disorders. Psychological and psychopathological analysis discloses the genesis of the headache mostly the psychological, social and occupational stressors which play an important role for the transformation of migraine into chronic one. Most recent studies also report that stress-related disorders and post-traumatic stress disorders are closely associated with migraine . One theory strongly suggest that migraine and psychiatric comorbidity share the common genetic factors, serotonergic processing and oestrogen response. In women, the prevalence of migraine and mood disorders are more common when compared to men. According to B Lee, Peter line study hypothesis states that oestrogen plays a role in the pathophysiology of migraine and mood disorders. Limbic system and HPA axis are inter linked in human beings and the estrogen modulates and exerts agonistic action on serotonergic system.
ABSTRACTBackground: Co morbidity between headache and psychiatric disorders is more prevalent in chronic headache patients. The bipolar disorders and anxiety disorders are predominant in migraine and TTH respectively. This co morbidities have a poor reflection and impact on quality and outcome of chronic headache patients and results in worst prognosis and poor response to medical treatment. Methods: The chronic headache patients especially migraine and tension type of headache were analyzed with following materials such as the structured psychiatric clinical interview with ICD-10 mental and behavioural disorder, DSM-5 criteria. HAM-A, HAM-D, BDI-2, BPRS, young mania rating scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and panic disorder scale. Results: Various subsets of bipolar disorder and anxiety disorder were found as follows: 74% of migraineurs are associated with psychiatric disorders in which bipolar affective disorder 6%, depressive episode 48%, dysthymia 30%, GAD 10% and Panic disorder 6%. 52% of TTH are associated with psychiatric disorders as follows: major depressive episode 52%, GAD 30%, separation anxiety disorder 6%, PTSD 7%, OCD 3% and panic disorder 2%. Conclusions: From previous and future studies the headache can be identified according to subsets of headache with psychiatric disorders make easier to provide appropriate pharmacological and psychological treatment which may reduce the chronicity and intractability of headache.