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[Chronic tension-type headache and depression]
1Servicio de Neurología, Hospital Carlos Andrade Marín, Facultad de Medicina de la Pontificia Universidad Católica del Ecuador, Quito, Ecuador. serranom@pi.pro.ec
Introduction:
Tension-type headache (TTH) is the commonest head pain to be seen in medical practice and is erroneously thought to have a psychogenic origin.
Objective:
To evaluate the presence of depression in a cohort of persons with TTH and compare them with patients with migraine and with a control group. The clinical characteristics of patients with TTH were also noted.
Patients And Methods:
We studied 89 patients with chronic TTH. Their level of depression (on the Hamilton scale) was compared with 31 patients with migraine with typical aura and a control group of 34 asymptomatic volunteers, matched for age, marital and job status.
Results:
No difference was observed in the index of depression of the group of patients with chronic TTH as compared with the control group with migraine: p < 0.9412 and OR 1.07. Compared with the asymptomatic control group: p < 0.0272 and OR 3.81, which are significant figures. After 11 months of prophylactic treatment with imipramine (50 mg/day), levels of depression persisted in 20.02% of the patients, p < 0.06319 and OR 2.01 even when treatment was optimum in 98.8%.
Conclusions:
Patients with chronic TTH showed indices of depression in 33.7%. This figure was similar in those with migraine, 32.2%. Also response to treatment was independent of this figure. In 48% of the patients there was fear of having cerebral vascular disease.