Psychiatric comorbidity in new daily persistent headache: A cross-sectional study

Area of Science:

• Neurology
• Psychiatry
• Pain Medicine

Background:

• New daily persistent headache (NDPH) is a chronic daily headache disorder.
• NDPH can present with migrainous (NDPH-CM) or tension-type (NDPH-CTTH) features.
• Recent observations suggest a link between NDPH and co-occurring anxiety and depression.

Purpose of the Study:

• To compare anxiety, depressive symptoms, somatization, and pain catastrophization in NDPH patients versus healthy controls and chronic low-back pain patients.
• To differentiate these psychological factors between NDPH-CM and NDPH-CTTH subtypes.

Main Methods:

• Utilized Patient Health Questionnaire-9 for depressive symptoms and Generalized Anxiety Disorder Scale-7 for anxiety.
• Assessed somatoform disorders using DSM IV (TR) criteria and pain catastrophizing with the Pain Catastrophizing Scale.
• Enrolled 55 NDPH patients, 55 healthy controls, and 55 chronic low-back pain patients, matched for age and sex.

Main Results:

• NDPH patients exhibited significantly higher frequencies of anxiety, depression, somatization, and pain catastrophization compared to both control groups.
• Specific findings in NDPH patients included 32.7% somatoform disorder, 65.5% severe anxiety, 40% severe depressive symptoms, and 85.5% significant pain catastrophization.
• NDPH-CM patients showed higher rates of depression and pain catastrophization than NDPH-CTTH patients.

Conclusions:

• Anxiety, depressive symptoms, somatization, and pain catastrophization are significantly more prevalent in NDPH patients.
• These psychological comorbidities may contribute to treatment resistance in NDPH.
• Screening for and addressing these factors is crucial for managing NDPH effectively.