Headache, anxiety and depressive disorders: the HADAS study

Area of Science:

• Neurology
• Psychiatry
• Epidemiology

Background:

• The association between headache disorders and psychiatric conditions is well-established.
• Previous studies on headache and psychiatric comorbidities lack standardization, hindering direct comparisons.
• Understanding these comorbidities is crucial for comprehensive patient care.

Purpose of the Study:

• To assess the prevalence and characteristics of anxiety and depression in patients with migraine without aura and tension-type headache (TTH).
• To investigate psychiatric comorbidities in isolated TTH, isolated migraine without aura, and combined migraine and TTH.
• To explore potential shared risk factors and pathophysiological mechanisms.

Main Methods:

• A structured interview and the MINI (Mini-International Neuropsychiatric Interview) were used.
• 158 adults with migraine without aura and 216 individuals with TTH or migraine plus TTH were assessed.
• Prevalence rates for depressive episodes, anxiety, panic disorder, and obsessive-compulsive disorder were calculated.

Main Results:

• Psychiatric disorders were reported in 10.9% of migraine, 12.8% of TTH, and 21.4% of migraine plus TTH groups.
• Depressive episodes were highly prevalent across all groups (59.9-69.6%).
• Panic disorder was significantly more prevalent in migraine patients (OR 2.9) and even higher when compared to pure TTH (OR 6.3). Obsessive-compulsive disorder was also elevated in migraine plus TTH (OR 4.8).

Conclusions:

• Migraine and tension-type headache are frequently associated with significant psychiatric comorbidities, particularly anxiety and depressive disorders.
• The findings suggest shared underlying risk factors and pathophysiological mechanisms contributing to both primary headache disorders and psychiatric conditions.
• These comorbidities represent a significant disease burden and highlight the need for integrated treatment approaches.