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Headache and psychiatric comorbidity: clinical aspects and outcome in an 8-year follow-up study
V Guidetti1, F Galli, P Fabrizi
1Interuniversity Center for the Study of Headaches and Neurotransmitter Disorders, Section of Rome, Italy. v.guidetti@iol.it
Unlabelled:
Migraine with juvenile onset changes over time. The existence of prognostic factors is a point of focus. A strict relationship between migraine or tension-type headache (TTH) and psychiatric factors has been suggested, but the exact role and the influence on evolution of headache is unknown.
Objective:
To analyze the evolution of migraine and TTH and psychiatric comorbidity (P-Co) from 1988 to 1996.
Material And Method:
100 subjects (40M, 60F; mean age 17.9 years; SD 2.7 years; range 12-26 years) were examined at our Center. The International Headache Society (IHS) criteria were employed. Psychometric tests and clinical interviews aided psychiatric diagnosis (DSM-III-R). SCID (Structured Clinical Interview for DSM-III-R) was employed in 1996. Chi square and logistic regression are used for statistical analysis.
Findings:
Migraine and TTH change their clinical characteristics, with a high tendency to remission (mostly in males). The presence of P-Co in 1988 is related to a worsening or unchanging situation in 1996. Headache-free subjects did not present any psychiatric disorders in 1996. Anxiety disorders in 1988 are related to enduring of headache. Migraine shows comorbidity with anxiety disorders and depression.
Conclusion:
P-Co is a notable problem in clinical practice. Diagnostic, prognostic, and treatment implications require a systematic assessment of P-Co.