Mood and Anxiety Disorders in Chronic Headache

Abstract

Although most individuals with recurrent headache disorders in the general population do not experience severe psychopathology, population-based studies and clinical investigations find high rates of comorbidity between headache and mood and anxiety disorders. When present, psychiatric disorders may complicate headache treatment and portend a poorer treatment response. The negative prognosis associated with psychiatric comorbidity emphasizes the importance of the identification of psychopathology among those with headache beginning at an early age, and suggests that the treatment of psychiatric comorbidity is warranted to improve the outcome of headache management.In this article we describe the mood and anxiety disorders most commonly associated with migraine, tensiontype headache, and chronic daily headache. We provide recommendations for the assessment of comorbid mood and anxiety disorders as well as a brief overview of treatment options. Last, we discuss the clinical implications of mood and anxiety disorders on the treatment and outcome of headache.

Tension-Type Headache: A Life-Course Review

“…Our findings also add to evidence that TTH is frequently co-morbid with anxiety and depression [57] and with reports of repressed anger and resentment [57][58][59]. We also found that adults with TTH were less antisocial in childhood and less aggressive during adolescence and early adulthood than individuals …”

“…The gray matter reduction correlated with lifetime duration of headache. There is [94] Problem solving, stress, depression Baskin SM et al, (2006) [57] Anxiety, depression, Adler CS et al, (1987) [58] Repressed anger, resentment [60] Lower aggression, less antisocial Waldie KE. (2001) [54] Stress about bodily changes Aaseth K et al, (2010) [73], Bell BD et al, (1999) [81] Changes in brain structure …”

Does number of lifetime traumas explain the relationship between PTSD and chronic medical conditions? Answers from the National Comorbidity Survey-Replication (NCS-R)

“…Further, the relationship between PTSD and headaches remained even after controlling for the number of lifetime traumas. Comorbidity between mood disorders, anxiety disorders, and headaches is well known; however, little research has focused on the relationship between PTSD symptomatology and headaches (Baskin, Lipchik, & Smitherman, 2006;Griffith & Razavi, 2006).…”

“…Further, the relationship between PTSD and headaches remained even after controlling for the number of lifetime traumas. Comorbidity between mood disorders, anxiety disorders, and headaches is well known; however, little research has focused on the relationship between PTSD symptomatology and headaches (Baskin, Lipchik, & Smitherman, 2006;Griffith & Razavi, 2006).The current findings should be interpreted within the context of study limitations. Assessment of chronic medical conditions relied on self-report rather than official medical records; however, research has demonstrated high concordance rates between self-reported medical conditions and medical records and agreement is especially high for stroke (Horner, Cohen, & Blazer, 2001;Okura, Urban, Mahoney, Jacobsen, & Rodeheffer, 2004;Simpson, Boyd, Carlson, Griswold, Guralnik, & Fried, 2004), heart attack (Okura et al, 2004), cancer (Simpson et al, 2004), and diabetes (Kehoe, Wu, Leske, & Chylack, 1994;Kriegsman, Penninx, van Eijk, Boeke, & Deeg, 1996;Simpson et al, 2004).…”

Line bisection in medication-overuse and chronic tension-type headaches

“…In order to exclude the effect of chronic head pain, we have included a group of patients with CTTH. Bearing in mind that patients with generalized anxiety disorder bisected lines significantly leftward [23], and that both anxiety and depression are comorbid with MOH [24,25] and CTTH [26][27][28], we have used the Zung Self-Rating Anxiety Scale [29] and the Zung Self-Rating Depression Scale [30] to measure the anxiety and depression levels in our participants. the Zung 20-item Self-rating Anxiety Scale [29].…”