Original

The Journal of Headache and Pain

, Volume 11, Issue 2, pp 141-150

Open Access This content is freely available online to anyone, anywhere at any time.

Headache, anxiety and depressive disorders: the HADAS study

  • Ettore BeghiAffiliated withDipartimento di Neuroscienze, Istituto “Mario Negri”Istituto di Ricerche Farmacologiche “Mario Negri” Email author 
  • , Gennaro BussoneAffiliated withDipartimento Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico C. Besta
  • , Domenico D’AmicoAffiliated withDipartimento Neuroscienze Cliniche, Fondazione IRCCS Istituto Neurologico C. Besta
  • , Pietro CortelliAffiliated withDipartimento di Scienze Neurologiche, Università degli Studi di Bologna
  • , Sabina CevoliAffiliated withDipartimento di Scienze Neurologiche, Università degli Studi di Bologna
  • , Gian Camillo ManzoniAffiliated withCentro Cefalee, Sezione di Neurologia, Dipartimento di Neuroscienze, Università degli Studi di Parma
  • , Paola TorelliAffiliated withCentro Cefalee, Sezione di Neurologia, Dipartimento di Neuroscienze, Università degli Studi di Parma
  • , Maria Clara ToniniAffiliated withCentro Cefalee Ospedale “G.Salvini”
  • , Giovanni AllaisAffiliated withCentro Cefalee Della Donna, Dipartimento Discipline Ginecologiche ed Ostetriche, Università degli studi di Torino
    • , Roberto De SimoneAffiliated withCentro Cefalee e Clinica Neurologica, Università Federico II
    • , Florindo D’OnofrioAffiliated withUnità Operativa Complessa di Neurologia, Azienda Ospedaliera “SG Moscati” Avellino
    • , Sergio GencoAffiliated withClinica Neurologica I
    • , Franca MoschianoAffiliated withDipartimento di Neuroscienze, Istituto “Mario Negri”Unità Operativa Neurologia-Ospedale di Merate (LC)
    • , Massimiliano BeghiAffiliated withDipartimento di Neuroscienze, Istituto “Mario Negri”Clinica Psichiatrica, Università di Milano-Bicocca
    • , Sara SalviAffiliated withDipartimento di Neuroscienze, Istituto “Mario Negri”Area Terapeutica, SNC Direzione Medica, GSK

Abstract

The objective of this paper was to assess prevalence and characteristics of anxiety and depression in migraine without aura and tension-type headache, either isolated or in combination. Although the association between headache and psychiatric disorders is undisputed, patients with migraine and/or tension-type headache have been frequently investigated in different settings and using different tests, which prevents meaningful comparisons. Psychiatric comorbidity was tested through structured interview and the MINI inventory in 158 adults with migraine without aura and in 216 persons with tension-type headache or migraine plus tension-type headache. 49 patients reported psychiatric disorders: migraine 10.9%, tension-type headache 12.8%, and migraine plus tension-type headache 21.4%. The MINI detected a depressive episode in 59.9, 67.0, and 69.6% of cases. Values were 18.4, 19.3, and 18.4% for anxiety, 12.7, 5.5, and 14.2%, for panic disorder and 2.3, 1.1 and 9.4% (p = 0.009) for obsessive–compulsive disorder. Multivariate analysis showed panic disorder prevailing in migraine compared with the other groups (OR 2.9; 95% CI 1.2–7.0). The association was higher (OR 6.3; 95% CI 1.4–28.5) when migraine (with or without tension-type headache) was compared to pure tension-type headache. This also applied to obsessive–compulsive disorder (OR 4.8; 95% CI 1.1–20.9) in migraine plus tension-type headache. Psychopathology of primary headache can reflect shared risk factors, pathophysiologic mechanisms, and disease burden.

Keywords

Migraine Tension-type headache Depression Anxiety Prevalence