Frequency of Primary Headache Syndromes in Patients with a Major Depressive Disorder

Abstract

PurposeThe primary objective of this study was to assess the overall frequency of primary headaches in subjects with a moderate to severe major depressive disorder. A further objective was to determine the frequency of primary headache sub-types in this population.Materials and methodsThis descriptive, cross-sectional study was conducted at the outpatients’ clinic of the department of psychiatry, Pakistan Railways Teaching Hospital, an affiliate of Islamic International Medical College, Rawalpindi. The duration of the study was from December 2016 to May 2017. One hundred and ten consecutive patients with a major depressive disorder (MDD) were assessed for a primary headache, according to the diagnostic criteria of International Classification of Headache Disorders second edition (ICHD-2). MDD patients with moderate to severe depression according to the diagnostic and statistical manual of mental disorders (DSM-5) were enrolled in the study. A semi-structured proforma was designed to gather information on sociodemographic variables. The data was analyzed by utilizing Statistical Package for Social Sciences, version 22 (IBM Corp., Armonk, NY, US).ResultsOf the 110 MDD patients enrolled, a primary headache was present in 45 (40.90%) cases. Additionally, five of these patients had a migraine with aura (11.11%), 12 had a migraine without aura (26.66%), and 28 had a tension-type headache (62.22%). In the females, migraines with or without aura was frequent (35.29%), while a tension-type headache was more common in males (72.72%).ConclusionMore than one-third of the sample had a primary headache syndrome, which shows a high comorbidity between a migraine and its variants and MDD. There is a need to undertake further studies with larger samples to elucidate this relationship.

Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency: results of the migraine in America symptoms and treatment (MAST) study

“…Many medical conditions are more common in people with migraine compared to the general population [33]. There is a small body of literature examining rates of single medical conditions among people with and without migraine, and over the past decade, a growing body of literature has emerged examining the effect of headache day frequency on rates of migraine comorbidities and the effects of selected comorbidities on headache progression [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][22][23][24][25][26][27][28]. After adjusting for sociodemographic variables, the cohort with migraine was about three times more likely to report a medical diagnosis of insomnia, depression, anxiety, and gastric ulcer/GI bleeding.…”

“…Comorbidity is the greater than chance association between the two conditions in the same individual [2]. There are many comorbidities associated with migraine including cardiovascular disorders (i.e., stroke, myocardial infarction [3][4][5][6][7][8][9][10], psychiatric disorders (i.e., depression, anxiety, panic disorder, bipolar disorder, personality disorders, suicide attempts) [11][12][13][14][15][16][17][18][19][20][21], neurologic diseases (i.e., epilepsy), sleep conditions (i.e., insomnia, restless leg syndrome, sleep apnea, poor sleep quality and duration) [22][23][24], inflammatory conditions (i.e., allergic rhinitis, asthma) [25,26] as well as chronic pain conditions (i.e., fibromyalgia) [27], among many others [28]. Many comorbidities have been identified as risk factors for progression to chronic migraine [29] and recent work has shown that the combination of comorbidities or "multimorbidity" is associated with medication overuse and new onset CM [30,31].…”

“…Several studies have examined rates of single comorbidities comparing people with migraine and those without [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]28]. Data from a primary care database study conducted in Scotland found that patients with chronic migraine (defined differently from International Committee of Headache Disorders (ICHD) criteria as patients had ≥4 prescriptions for migraine in the past 12 months) were more likely to experience a comorbid condition compared to control patients [36].…”

Depression Among Patients with Chronic Cluster Headaches

“…Muneer et al conducted a study in which he assessed the frequency of primary headache syndrome among patients with major depressive disorder. His results demonstrate that around one-third of patients with depression have any of one underlying chronic headache syndromes [14]. There can be an underlying association between chronic headache syndromes and depression and further studies are required to evaluate it.…”

The Contribution of Rat Studies to Current Knowledge of Major Depressive Disorder: Results From Citation Analysis

“…For example, a big longitudinal study showed that people who present anxiety traits in their twenties are more prone to develop MDD in their thirties (Gustavson et al, 2018). Also Parkinson's, Migrains' , Alzheimer's patients, among others, have high prevalence of MDD (Ketharanathan et al, 2014;Muneer et al, 2018;Tao et al, 2019).…”