Primary headaches and generalized anxiety disorder comorbidity

Abstract

Anxiety disorders and headaches are comorbid conditions, but no research has been done on the prevalence and impact of primary headaches in generalized anxiety disorder (GAD) subjects. Objective: The study's aim was to analyze lifetime prevalence and impact of primary headaches in subjects with and without generalized anxiety disorder. Method: Sixty participants were enrolled in the study; 30 GAD subjects diagnosed according to the DSM-IV were compared to 30 healthy control subjects. All subjects were interviewed for psychiatric assessment using the SCID-I/P. Primary headaches were diagnosed using ICHD-II criteria for structured interview. Results: Migraine was the most common diagnosis in generalized anxiety disorder subjects. The prevalence of migraine was highest among GAD patients as opposed to controls (66.7% vs 13.3%; p<0.001; OR=13.00; 95% CI=3.55-47.6), episodic migraine (43.3% vs 10%; p=0.004; OR=6.88; 95% CI=1.71-27.75), chronic daily headache (20% vs 0; p=0.024) and aura (26.6% vs 3.3%; p=0.026; OR=10.55; 95% CI=1.23-90.67). Tension Type Headache was equal for controls and the GAD group (20% vs 33.3%; p=0.243).The characteristics of migraines (frequency, intensity, duration, and consumption of analgesics), symptoms such as anxiety, depression, fatigue, and daytime sleepiness, as well as the medical-social consequences (functional incapacity, use of health services and quality of life) were worse in GAD subjects than in controls. Conclusion: Primary headaches in general, and migraine in particular, are significantly more common in GAD subjects than controls. GAD aggravates headaches. Primary headache diagnosis is important for anxiety disorder patients, particularly those with GAD, since correct assessment may lead to better patient management and clinical outcomes.

Cephalalgiaphobia: a possible specific phobia of illness

“…Genetic, epidemiologic and clinical data confirm this association [6][7][8][9]. Cephalalgiaphobia can be possibly classified as an anxiety disorder, under the heading of specific phobias, different from other specific phobias.…”

“…Anxiety and mood disorders are the most important conditions in CM, affecting up to 85% of patients [2][3][4], causing significant decrease in their quality of life [5]. Anxiety disorders were found in 76% of CM patients, generalised anxiety disorder (GAD) in 52%, and phobias in 54% [6,7]. Social phobia is three-fold more common in migraineurs than in controls [8].…”