Prevalence of psychiatric co-morbidity in patients presenting with chronic daily headache: a hospital based cross sectional study

Abstract

Headaches are commonly associated with psychiatric disorders where psychiatrists are often consulted for the evaluation and treatment of people suffering from it. Most headaches are not associated with significant organic disease; many people are susceptible to headaches at times of emotional stress. The relationship between headache and psychiatric disorders is complex. ABSTRACTBackground: Headache is a common neurological disorder and most disabling conditions in the worldwide. Psychiatric disorders can occur with at least two to three-fold greater frequencies among the patients presenting with headache than among general population. The presence of psychiatric co-morbidity further complicates headache management and portends a poorer prognosis. Therefore, the present study of prevalence of psychiatric co-morbidity in patients presenting with headache and to know the nature and extent of psychiatric co-morbidity associated with headache among the patients was undertaken. Methods: Present sample consists of 100 patients who presented with the complaints of headache to the department of Psychiatry and Medicine from November 2012 to June 2014 was included in the study. MINI 5.0.0 was applied to elicit the presence of any Axis I and Axis II disorders respectively. Results: In this study 74% of the patients presenting with headache had co-morbid psychiatric disorders. Out of 74% of the psychiatric illnesses; 28% had affective spectrum disorders, 16% had anxiety disorders 16% had psychotic disorders, 12% had other neurotic stress related disorders, and 2% had personality disorder among the patients presenting with headache. Conclusions: Patients presenting with headache have high levels of co-morbid psychiatric disorders and the presence of headache in these patients was associated with increased severity of the co-morbid psychiatric conditions. In view of the present findings, the management of patients presenting with headache should include the detail assessment of coexisting psychopathology and treatment of both coexisting conditions.