The presence of psychiatric disorders reduces the likelihood of neurologic disease among referrals to a neurology clinic

Ekstrand, John R; O’Malley, Patrick G.; Labutta, Robert J.; Jackson, Jeffrey L.

doi:10.1016/s0022-3999(03)00564-6

Cited by 9 publications

(14 citation statements)

References 47 publications

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“…Ideally, screening measures should be validated on headache or similar medical patient populations. It would be particularly advantageous to develop and validate brief screening (eg, self‐report) tools that can be applied efficiently in physicians' practice settings to initially flag potential psychopathology 46,84 . With respect to treatment, both pharmacologic and behavioral therapies should be evaluated specifically on populations of headache patients with psychiatric disorders, who are routinely excluded from clinical trials research.…”

Section: Recommendations For Researchmentioning

confidence: 99%

Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance

Lake

Rains²,

Penzien³

2005

Headache

125

128

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The comorbidity of headache and psychiatric disorders is a well-recognized clinical phenomenon warranting further systematic research. Affective disorders occur with at least three-fold greater frequency among migraineurs than among the general population, and the prevalence increases in clinical populations, especially with chronic daily headache. When present, psychiatric comorbidity complicates headache management and portends a poorer prognosis for headache treatment. However, the relationship between headache and psychopathology has historically been misunderstood, and Headache has been associated with psychiatric illness in the medical literature for well over a century. Unfortunately, as noted by Silberstein and colleagues, 1 the relationship between headache and psychopathology has been clinically discussed far more often than it has been systematically studied. This relationship remains probably one of the most poorly understood, while at the same time clinically important, areas for future headache research. The present article provides a brief historical context for research examining headache and psychiatric comorbidity. Despite an arguably dubious genesis emerging from psychoanalytic case reports with little evidence supporting 493

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Section: Recommendations For Researchmentioning

confidence: 99%

Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance

Lake

Rains²,

Penzien³

2005

Headache

125

128

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“…Providers are often untrained and unmotivated to diagnose and treat headache patients [4,5,6,7,8,9,10] and many have an inappropriate perception of the burden of headache disorders [4,11] or consider headaches a somatoform disorder [12,13,14]. This results in misdiagnosis [6,11,15] and ineffective treatment [6,7,11], which increases patient dissatisfaction and insecurity [15] with consequent doctor ‘shopping', unnecessary testing and inadequate self-treatment.…”

Section: Introductionmentioning

confidence: 99%

Headache from the Doctors' Perspective

Gil‐Gouveia¹

2014

Eur Neurol

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Background: General practitioners (GPs) and neurologists are involved in treating headache patients in Portugal. Having migraine themselves might influence the way they perceive and treat migraine patients. Objective: To identify clinicians' perceptions about migraine, their own headache status and management of their own migraine. Methods: An observational cross-sectional survey of GPs and neurologists using anonymous questionnaires including demographic data, headache and migraine status and migraine perception questions. Results: Of 348 respondent physicians, 20% were neurologists and 53% were females with an average age of 48 years. The majority had an interest in migraine and considered it disabling (93%), although 65-85% reported management difficulties, GPs more often than neurologists. Satisfaction with current treatment options was high (69-79%). 63 physicians suffered from migraine and 81% felt it influenced their perception of the disease. Portuguese physicians preferentially treat their own migraines with NSAIDs (33%), analgesics (29%) and triptans (20%). Conclusion: Portuguese physicians treating migraine patients have realistic perceptions about the disease and those with migraine feel their perception is influenced by their experience. Although reporting management difficulties, the majority of physicians are satisfied with current treatment options for migraine.

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“…Other authors maintain the importance of anxiety symptoms in neurological patients [34, 35], but still there is not much data available [36]. Ekstrand et al [13] found that 39% of neurological patients displayed an underlying psychiatric disorder: depression and somatoform disorder were the most prevalent disorders. Those with a psychiatric disorder were less likely to have an underlying neurological process as the cause of their symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The probability of a simple migraine developing into a transformed migraine is increased if there is a co-morbid mental disease [12]. Headache patients appear to suffer from a co-morbid mental disease more frequently than general neurological patients [13, 14]. Little is known about the specific anxiety disorders in headache patients.…”

Section: Introductionmentioning

confidence: 99%

Anxiety disorders in headache patients in a specialised clinic: prevalence and symptoms in comparison to patients in a general neurological clinic

et al. 2011

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Data from several studies indicate an association of headache with anxiety disorders. In this study, we assessed and differentiated anxiety disorders in 100 headache patients by using the PSWQ (Penn State Worry Questionnaire) screening tool for generalised anxiety disorder (GAD) and the ACQ (Agoraphobic Cognitions Questionnaire) and BSQ (Body Sensation Questionnaire) for panic disorder (PD). Control groups were constructed: (1) on the basis of epidemiological studies on PD and GAD in the general population and (2) by including neurological patients. 37.0% of headache patients had a GAD. 27% of headache patients met the score for PD in the BSQ, 4.0% in the ACQ. Significant results were obtained in comparison to the general population (p < 0.001) and with regard to GAD in comparison with a sample of neurological patients (p < 0.005). The BSQ significantly correlated with the number of medication days (p < 0.005). The results confirm the increased prevalence of GAD in headache patients. PD seems to increase the risk of medication overuse.

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The presence of psychiatric disorders reduces the likelihood of neurologic disease among referrals to a neurology clinic

Cited by 9 publications

References 47 publications

Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance

Headache and Psychiatric Comorbidity: Historical Context, Clinical Implications, and Research Relevance

Headache from the Doctors' Perspective

Anxiety disorders in headache patients in a specialised clinic: prevalence and symptoms in comparison to patients in a general neurological clinic

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