Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes

Headache. Nov-Dec 2000;40(10):818-23. doi: 10.1046/j.1526-4610.2000.00148.x.

Abstract

Objective: To investigate the frequency of depressive and anxiety disorders in patients with chronic daily headache.

Background: There is a lack of data in the literature on the extent of psychiatric comorbidity in patients with different subtypes of chronic daily headache.

Methods: We recruited consecutive patients with chronic daily headache seen in a headache clinic from November 1998 to December 1999. The subtypes of chronic daily headache were classified according to the criteria proposed by Silberstein et al. A psychiatrist evaluated the patients according to the structured Mini-International Neuropsychiatric Interview to assess the comorbidity of depressive and anxiety disorders.

Results: Two hundred sixty-one patients with chronic daily headache were recruited. The mean age was 46 years, and 80% were women. Transformed migraine was diagnosed in 152 patients (58%) and chronic tension-type headache in 92 patients (35%). Seventy-eight percent of patients with transformed migraine had psychiatric comorbidity, including major depression (57%), dysthymia (11%), panic disorder (30%), and generalized anxiety disorder (8%). Sixty-four percent of patients with chronic tension-type headache had psychiatric diagnoses, including major depression (51%), dysthymia (8%), panic disorder (22%), and generalized anxiety disorder (1%). The frequency of anxiety disorders was significantly higher in patients with transformed migraine after controlling for age and sex (P =.02). Both depressive and anxiety disorders were significantly more frequent in women.

Conclusion: Psychiatric comorbidity, especially major depression and panic disorders, was highly prevalent in patients with chronic daily headache seen in a headache clinic. These results demonstrate that women and patients with transformed migraine are at higher risk of psychiatric comorbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / epidemiology*
  • Chronic Disease
  • Comorbidity
  • Depressive Disorder / epidemiology*
  • Female
  • Headache / classification
  • Headache / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / epidemiology
  • Sex Distribution
  • Tension-Type Headache / epidemiology