Psychopathology and Headache Syndromes in the Community

Abstract

The present study investigated the association between psychopathology and headache in a prospective longitudinal epidemiologic study of a cohort of 19-and 20-year-olds in Zurich, Switzerland. Prevalence rates of psychopathology by headache subtype were examined both cross-sectionally and longitudinally. Psychiatric disorders were evaluated using a direct interview administered by experienced clinicians. Personality was assessed using the Freiburg Personality Inventory and the Symptom Checklist 90. In general, subjects with migraine had more affective and anxiety disorders and exhibited elevated rates of neuroticism and somatization compared to nonmigraine subjects. When examined by headache subtype, migraineurs with aura exhibited greater rates of psychopathology and more personality abnormalities than any of the other headache subtypes or controls. In contrast to clinical wisdom, subjects with tension-type headache did not differ from controls in rates of psychopathology or on any of the personality or symptom factors.

Do accompanying symptoms in women with migraine allow distinction between two separate patient groups?

“…In epidemiologic studies an association was found between migraine and panic attacks [11] and both depression and anxiety disorders [12][13][14][15][16][17]. This was confirmed by prospective studies [18][19][20]. Some caution in interpreting our data is requested by the fact that the work was performed on a selected sample of patients seeking treatment in a specialty center.…”

“…This issue also relates to the problem whether an association exists between personality changes and migraine. While clinical investigations using the Minnesota multipolar personality inventory (MMPI) in migraine patients led to controversial results [6][7][8][9][10][11][12][13], epidemiologic and prospective studies [14][15][16][17][18][19][20][21][22][23] have confirmed this association. On the other hand, since behavioral and somatic symptoms are observed in patients with anxiety, mood and somatoform disorders [24], the assessment of their prevalence in a migraine patient population may be of help in evaluating the psychogenic component in these patients.…”

Sexual dysfunction in women with migraine versus tension-type headaches: a comparative study

“…[24][25][26][27] Fewer studies have been published assessing tension-type headaches and psychiatric comorbidity. Nonetheless, the evidence is fairly consistent that tension headache patients are more likely than healthy controls to suffer from psychiatric disorders, especially anxiety and depression.…”

The Temperament and Character Inventory in women with migraine

“…Highly HA individuals are described as extremely careful, passive, fearful, insecure and prone to react with a high rate of anxiety and depression to stressful events, while high P levels express the tendency to maintain unrewarded behaviours and correlate with rigidity and obsessiveness [1]. Low levels of SDir are an important predictor of categorical diagnosis of DSM Axis I disorders which are frequently associated with migraine [5][6][7][8].…”

“…As mood and anxiety disorders are a frequent finding in headache patients [5][6][7][8], the question arises as the extent to which the differences in TCI dimensions observed in migraine patients depend on the headache pathology or on the presence of depression. Both pathologies are indeed characterised by the involvement of the serotoninergic system.…”