PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of headpainSpringerOpen.comSubmit OnlineRegisterThis journalThis article
 
J Headache Pain. 2010 April; 11(2): 141–150.
Published online 2010 January 27. doi:  10.1007/s10194-010-0187-2
PMCID: PMC3452290

Headache, anxiety and depressive disorders: the HADAS study

Abstract

The objective of this paper was to assess prevalence and characteristics of anxiety and depression in migraine without aura and tension-type headache, either isolated or in combination. Although the association between headache and psychiatric disorders is undisputed, patients with migraine and/or tension-type headache have been frequently investigated in different settings and using different tests, which prevents meaningful comparisons. Psychiatric comorbidity was tested through structured interview and the MINI inventory in 158 adults with migraine without aura and in 216 persons with tension-type headache or migraine plus tension-type headache. 49 patients reported psychiatric disorders: migraine 10.9%, tension-type headache 12.8%, and migraine plus tension-type headache 21.4%. The MINI detected a depressive episode in 59.9, 67.0, and 69.6% of cases. Values were 18.4, 19.3, and 18.4% for anxiety, 12.7, 5.5, and 14.2%, for panic disorder and 2.3, 1.1 and 9.4% (p = 0.009) for obsessive–compulsive disorder. Multivariate analysis showed panic disorder prevailing in migraine compared with the other groups (OR 2.9; 95% CI 1.2–7.0). The association was higher (OR 6.3; 95% CI 1.4–28.5) when migraine (with or without tension-type headache) was compared to pure tension-type headache. This also applied to obsessive–compulsive disorder (OR 4.8; 95% CI 1.1–20.9) in migraine plus tension-type headache. Psychopathology of primary headache can reflect shared risk factors, pathophysiologic mechanisms, and disease burden.

Keywords: Migraine, Tension-type headache, Depression, Anxiety, Prevalence

Full Text

The Full Text of this article is available as a PDF (171K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
1. Pompili M, Di Cosimo D, Innamorati M, Lester D, Tatarelli R, Martelletti P. Psychiatric comorbidity in patients with chronic daily headache and migraine: a selective overview including personality traits and suicide risk. J Headache Pain. 2009;10:283–290. doi: 10.1007/s10194-009-0134-2. [PMC free article] [PubMed] [Cross Ref]
2. Hamelsky SW, Lipton RB. Psychiatric comorbidity of migraine. Headache. 2006;46:1327–1333. doi: 10.1111/j.1526-4610.2006.00576.x. [PubMed] [Cross Ref]
3. Wang SJ, Juang KD. Psychiatric comorbidity of chronic daily headache: impact, treatment, outcome, and future studies. Curr Pain Headache Rep. 2002;6:505–510. doi: 10.1007/s11916-002-0071-0. [PubMed] [Cross Ref]
4. Ferrari MD, Odink J, Tapparelli C, Kempen GM, Pennings EJ, Bruyn GW. Serotonin metabolism in migraine. Neurology. 1989;39:1239–1242. [PubMed]
5. Shechter AL, Lipton RB, Silberstein SD. Migraine comorbidity. In: Silberstein SD, Lipton RB, Dalessio DJ, editors. Wolff’s headache and other head pai. 7. Oxford: University Press; 2001. pp. 108–118.
6. Heckman BD, Holroyd KA. Tension-type headache and psychiatric comorbidity. Curr Pain Headache Rep. 2006;10:439–447. doi: 10.1007/s11916-006-0075-2. [PubMed] [Cross Ref]
7. American Psychiatric Association <http://www.psych.org/> (2000) Diagnostic and statistical manual of mental disorders, 4th edn. Washington DC, Text Revision
8. Headache classification subcommittee of the international headache society The international classification of headache disorders: 2nd edn. Cephalalgia. 2004;24(Suppl 1):9–160. [PubMed]
9. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33. [PubMed]
10. Breslau N, Davis GC, Andreski P. Migraine, psychiatric disorders and suicide attempts. An epidemiological study of young adults. Psychiatry Res. 1991;37:11–23. doi: 10.1016/0165-1781(91)90102-U. [PubMed] [Cross Ref]
11. Breslau N, Schultz LR, Stewart WF, Lipton RB, Lucia VC, Welch KM. Headache and major depression: Is the association specific to migraine? Neurology. 2000;54:308–313. [PubMed]
12. Perozzo P, Savi L, Castelli L, et al. Anger and emotional distress in patients with migraine and tension-type headache. J Headache Pain. 2005;6:392–399. doi: 10.1007/s10194-005-0240-8. [PMC free article] [PubMed] [Cross Ref]
13. Mongini F, Rota E, Deregibus A, et al. Accompanying symptoms and psychiatric comorbidity in migraine and tension-type headache patients. J Psychosom Res. 2006;61:447–451. doi: 10.1016/j.jpsychores.2006.03.005. [PubMed] [Cross Ref]
14. Breslau N, Davis GC. Migraine, physical health and psychiatric disorders: a prospective epidemiologic study in young adults. J Psychiatr Res. 1993;27:211–221. doi: 10.1016/0022-3956(93)90009-Q. [PubMed] [Cross Ref]
15. Stewart WF, Linet MS, Celentano DD. Migraine headaches and panic attacks. Psychosom Med. 1989;51:559–569. [PubMed]
16. Stewart WF, Shecther A, Liberman J. Physician consultation for headache pain and history of panic: Results from a population-based study. Am J Med. 1992;92:35S–40S. doi: 10.1016/0002-9343(92)90135-X. [PubMed] [Cross Ref]
17. Stewart WF, Breslau N, Keck PE., Jr Comorbidity of migraine and panic disorder. Neurology. 1994;44:23–27. [PubMed]
18. Marazziti D, Toni C, Pedri S, et al. Prevalence of headache syndromes in panic disorder. Int Clin Psychopharmacol. 1999;14:247–251. doi: 10.1097/00004850-199907000-00007. [PubMed] [Cross Ref]
19. Jette N, Patten S, Williams J, Becker W, Wiebe S. Comorbidity of migraine and psychiatric disorders. A national population-based study. Headache. 2008;48:501–516. doi: 10.1111/j.1526-4610.2007.00993.x. [PubMed] [Cross Ref]
20. Breslau N, Schultz LR, Stewart WF, Lipton R, Welch KMA. Headache types and panic disorder. Directionality and specificity. Neurology. 2001;56:350–354. [PubMed]
21. Lipton RB, Silberstein SD. Why study the comorbidity of migraine? Neurology. 1994;44:S4–S5. [PubMed]
22. Bell CJ, Nutt DJ. Serotonin and panic. Br J Psychiatry. 1998;172:465–471. doi: 10.1192/bjp.172.6.465. [PubMed] [Cross Ref]
23. Loi V, Lai M, Pisano MR, Del Zompo M. Sumatriptan and panic-like symptoms. Am J Psychiatr. 1996;153:1505. [PubMed]
24. Arena J, Blanchard EB, Andrasik F, Applebaum K. Obsessions and compulsions in three kinds of headache sufferers: analysis of the maudsley questionnaire. Behav Res Ther. 1986;2:127–132. doi: 10.1016/0005-7967(86)90083-5. [PubMed] [Cross Ref]
25. Merikangas KR, Merikangas JR, Angst J. Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res. 1993;27:197–210. doi: 10.1016/0022-3956(93)90008-P. [PubMed] [Cross Ref]
26. Oedegaard KJ, Neckelmann D, Mykletun A, et al. Migraine with and without aura: association with depression and anxiety disorder in a population-based study. The HUNT study. Cephalalgia. 2006;26:1–6. doi: 10.1111/j.1468-2982.2005.00974.x. [PubMed] [Cross Ref]
27. Hung CI, Liu CY, Juang YY, Wang SJ. The impact of migraine on patients with major depressive disorders. Headache. 2006;46:469–477. doi: 10.1111/j.1526-4610.2006.00378.x. [PubMed] [Cross Ref]
28. Jelinski SE, Magnusson JE, Becker WJ, CHORD Study Group Factors associated with depression in patients referred to headache specialists. Neurology. 2007;68:489–495. doi: 10.1212/01.wnl.0000253183.57001.b3. [PubMed] [Cross Ref]
29. Swartz KL, Pratt LA, Armenian HK, Lee LC, Eaton WW. Mental disorders and the incidence of migraine headaches in a community. Arch Gen Psychiatr. 2000;57:945–950. doi: 10.1001/archpsyc.57.10.945. [PubMed] [Cross Ref]
30. Breslau N, Lipton RB, Stewart WF, Schultz LR, Welch KM. Comorbidity of migraine and depression. Investigating potential etiology and prognosis. Neurology. 2003;60:1308–1312. [PubMed]

Articles from The Journal of Headache and Pain are provided here courtesy of Springer