Greater Frequency of Depression Associated with Chronic Primary Headaches Than Chronic Post-Traumatic Headaches. (April 2013)

• Record Type: Journal Article
• Authors: McMurtray, Aaron M.; Saito, Erin K.; Diaz, Natalie; Mehta, Bijal; Nakamoto, Beau
• Is Part Of: International journal of psychiatry in medicine. Volume 45:Number 3(2013)
• Page Start: 227
• Page End: 236
• Publication Date: 2013-04
• Subjects: chronic pain -- depression -- headache; Psychiatry -- Periodicals; Sick -- Psychology -- Periodicals; Medicine, Psychosomatic -- Periodicals; 616.89005
• DOI: 10.2190/PM.45.3.b
• Languages: English
• ISSNs: 0091-2174

Abstract

Objective: To compare the prevalence of co-morbid depression between patients with chronic primary headache syndromes and chronic posttraumatic headaches. Method: A prospective cross-sectional analysis of all patients presenting sequentially to a community-based general neurology clinic during a 2-year period for evaluation of chronic headache pain was conducted. Headache diagnosis was determined according to the International Headache Society's Headache Classification criteria. Depression was determined through a combination of scores on the clinician administered Hamilton Rating Scale for Depression and patients' self-report. An additional group of patients who suffered traumatic brain injuries (TBI) but did not develop post-traumatic headaches was included for comparison. Results: A total of 83 patients were included in the study: 45 with chronic primary headaches (24 with chronic migraine headaches, 21 with chronic tension headaches), 24 with chronic post-traumatic headaches, and 14 with TBI but no headaches. Depression occurred less frequently among those with chronic post-traumatic headaches (33.3%) compared to those with chronic migraine (66.7%) and chronic tension (52.4%) headaches (Chi-Square = 7.68; df = 3; p = 0.053), and did not significantly differ from TBI patients without headaches. A multivariate logistic regression model using depression as the outcome variable and including headache diagnosis, gender, ethnicity, and alcohol and illicit substance use was statistically significant (Chi-Square = 27.201; df = 10; p < 0.01) and identified primary headache (migraine and tension) diagnoses (Score = 7.349; df = 1; p = 0.04) and female gender (Score = 15.281; df = 1; p < 0.01) as significant predictor variables. The overall model accurately predicted presence of co-morbid depression in 74.7% of the cases. Conclusions: Co-morbid depression occurs less frequently among patients with chronic post-traumatic headaches and TBI without headaches than among those with chronic primary headaches.