Current Pain and Headache Reports

, Volume 6, Issue 6, pp 492–497 | Cite as

Psychiatric comorbidity in chronic daily headache: Pathophysiology, etiology, and diagnosis

  • Vincenzo Guidetti
  • Federica Galli

Abstract

Chronic daily headache is a challenge for clinical practitioners and researchers. Etiology, pathophysiology, diagnosis, treatment, and prognosis of chronic daily headache present many questions that need answers. A chance occurrence of psychiatric disorders (mostly anxiety and mood disorders) in patients with chronic daily headache should not be excluded. This results in the need to understand the involved mechanisms, which requires us to draw new insights into the etiology, diagnosis, treatment, and prognosis of chronic daily headache. Psychiatric comorbidity seems to be cross-related to each of these dimensions, although the meanings need to be drawn. Each domain is discussed, considering the status of knowledge and stressing the future lines of research.

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References and Recommended Reading

  1. 1.
    Fusco BM, Colantoni O, Giacovazzo M: Alteration of central excitation circuits in chronic headache and analgesic misuse. Headache 1997, 37:486–491.PubMedCrossRefGoogle Scholar
  2. 2.
    Jensen R: Pathophysiologic mechanisms of tension-type headache: a review of epidemiologic and experimental studies. Cephalalgia 1999, 19:602–621.PubMedCrossRefGoogle Scholar
  3. 3.
    Sarchielli P, Alberti A, Floridi A, Gallai V: Levels of nerve growth factor in cerebrospinal fluid of chronic daily headache patients. Neurology 2001, 57:132–134.PubMedGoogle Scholar
  4. 4.
    Srikiatkhachorn A: Pathophysiology of chronic daily headache. Curr Pain Headache Rep 2001, 5:537–544.PubMedGoogle Scholar
  5. 5.
    Peres MF, Sanchez del Rio M, Seabra ML, et al.: Hypothalamic involvement in chronic migraine. J Neurol Neurosurg Psychiatry 2001, 71:747–751. Evidence for hypothalamic involvement in chronic migraine, shown by a chronobiologic dysregulation, and a possible hyperdopaminergic state.PubMedCrossRefGoogle Scholar
  6. 6.
    Jensen TS: Recent advances in pain research: implications for chronic headache. Cephalalgia 2001, 21:765–769. Neuronal hyperexcitability is a key phenomenon in many types of chronic pain. Preventive measures and endogenous pain modulation are areas of treatment to explore for chronic daily headache.PubMedCrossRefGoogle Scholar
  7. 7.
    Evans RW, Rozen TD: Etiology and treatment of new daily persistent headache. Cephalalgia 2001, 41:830–832.Google Scholar
  8. 8.
    Ashina M, Stallknecht B, Bendsten L, et al.: In vivo evidence of altered skeletal muscle blood flow in chronic tension-type headache. Brain 2002, 125:320–326. This article demonstrates evidence of the increased excitability of neurones in the central nervous system; the central interpretation and response to normal sensory input are altered in patients with chronic tension-type headache.PubMedCrossRefGoogle Scholar
  9. 9.
    Kudrow L: Paradoxical effects of frequent analgesic use. Adv Neurol 1982, 33:335–341.PubMedGoogle Scholar
  10. 10.
    Osler H: Migraine treatment as a cause of chronic migraine. In Advances in Migraine Research and Therapy. Edited by Rose FC. New York: Raven Press; 1982:159–164.Google Scholar
  11. 11.
    Rapoport AM: Analgesic rebound headache. Headache 1988, 28:662–665.PubMedCrossRefGoogle Scholar
  12. 12.
    Mathew NT, Stubits E, Nigman MR: Transformation of episodic migraine into daily headache: analysis of factors. Headache 1982, 22:66–68.PubMedCrossRefGoogle Scholar
  13. 13.
    Kappler JA: Rebound headache: definition, symptomatology, treatment, and prevention. Headache Q 1992, 3:39–40.Google Scholar
  14. 14.
    Mathew NT: Chronic refractory headache. Neurology 1993, 43(suppl):26S-33S.Google Scholar
  15. 15.
    Srikiatkhachorn A, Govitrapong P, Limthavon C: Up-regulation of 5HT2 serotonin receptor: a possible mechanism of transformed migraine. Headache 1994, 34:8–11.PubMedCrossRefGoogle Scholar
  16. 16.
    Capobianco DJ, Swanson JW, Dodick DW: Medication-induced (analgesic rebound) headache: historical aspects and initial descriptions of the North America experience. Headache 2001, 41:500–502.PubMedCrossRefGoogle Scholar
  17. 17.
    Silberstein SD, Schulman EA, Hopkins MM: Repetitive intravenous DHE in the treatment of refractory headache. Headache 1990, 30:334–339.PubMedCrossRefGoogle Scholar
  18. 18.
    Konno S, Stirling Meyer J, Margishvili GM, et al.: Transformed migraine is a cause of chronic daily headaches. Headache 1999, 39:95–100.PubMedCrossRefGoogle Scholar
  19. 19.
    Castillo J, Munoz P, Guitera V, Pascual J: Epidemiology of chronic daily headache in the general population. Headache 1999, 39:190–196.PubMedCrossRefGoogle Scholar
  20. 20.
    Headache Classification Committee of the International Headache Society: Classification and diagnostic criteria of headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988, 8(suppl 7):1–96.Google Scholar
  21. 21.
    Silberstein SD: Tension-type and chronic daily headache. Neurology 1993, 43:1644–1649.PubMedGoogle Scholar
  22. 22.
    Silberstein SD, Lipton RB, Solomon S, Mathew NT: Classification of daily and near-daily headaches: proposed revisions to the IHS criteria. Headache 1994, 34:1–7.CrossRefGoogle Scholar
  23. 23.
    Manzoni GC, Granella F, Sandrini G, et al.: Classification of chronic daily headache by International Headache Society criteria: limits and new proposals. Cephalalgia 1995, 15:37–43.PubMedCrossRefGoogle Scholar
  24. 24.
    Silberstein SD, Lipton RB: Chronic daily headache. Curr Opin Neurol 2000, 13:277–283. A review of the current understanding of chronic daily headache in adults with reference to classification, psychiatric comorbidity, epidemiology, pathophysiology, and treatment.PubMedCrossRefGoogle Scholar
  25. 25.
    Sandrini G, Cecchini AP, Tassorelli C, Nappi G: Diagnostic issues in chronic daily headache. Curr Pain Headache Rep 2001, 5:551–556.PubMedGoogle Scholar
  26. 26.
    Peres MF, Silberstein SD, Nahamias S, et al.: Heamicrania continua is not that rare. Neurology 2001, 57:948–951.PubMedGoogle Scholar
  27. 27.
    Li D, Rozen TD: The clinical characteristics of new daily persistent headache. Cephalalgia 2002, 22:66–69.PubMedCrossRefGoogle Scholar
  28. 28.
    Holden EW, Gladstein J, Trulsen M, Wall B: Chronic daily headache in children and adolescents. Headache 1994, 34:508–514.PubMedCrossRefGoogle Scholar
  29. 29.
    Gladstein J, Holden EW: Chronic daily headache in children and adolescents: a 2-year prospective study. Headache 1996, 36:349–351.PubMedCrossRefGoogle Scholar
  30. 30.
    Gladstein J, Holden EW, Winner P, Linder S, et al.: Chronic Daily Headache in children and adolescents: current status and recommendations for the future. Headache 1997, 37:626–629.PubMedCrossRefGoogle Scholar
  31. 31.
    Hershey AD, Powers SW, Bentti AL, et al.: Characterization of chronic daily haeadaches in children in a multidisciplinary headache center. Neurology 2001, 56:1032–1037. This article gives a description of the clinical characteristics of chronic daily headache, with onset in children and adolescents according to the presence of time trend and symptomologic characteristics.PubMedGoogle Scholar
  32. 32.
    Abu-Arafeh I: Chronic tension-type headache in children and adolescents. Cephalalgia 2001, 21:830–836. Application of the International Headache Society classification to chronic daily headache, with onset in children and adolescents.PubMedCrossRefGoogle Scholar
  33. 33.
    Arruda MA, Bordini CA, Ciciarelli MA, Speciali JG: Chronic headcahe in childhood: evaluation of IHS criteria and a proposal for modification. Cephalalgia 2001, 21:287.CrossRefGoogle Scholar
  34. 34.
    Diener HC, Katasarva Z: Analgesic/abortive overuse and misuse in chronic daily headache. Curr Pain Headache Rep 2001, 5:545–550.PubMedGoogle Scholar
  35. 35.
    Katsarava Z, Fritsche G, Muessig M, et al.: Clinical features of withdrawal headache following overuse of triptans and other headache drugs. Neurology 2001, 13:1694–1698. The consequences of withdrawal from headache medications are related to the type of drug withdrawal, with shorter and less severe symptoms in patients overusing triptans than in those overusing other analgesics.Google Scholar
  36. 36.
    Pini LA, Cicero AF, Sandrini M: Long-term follow-up of patients treated for chronic headache with analgesic overuse. Cephalalgia 2001, 21:878–883. Analgesic overuse influences the clinical outcome (4-year follow-up), the quality of life, and the persistence of drug abuse in patients with chronic daily headache.PubMedCrossRefGoogle Scholar
  37. 37.
    Curioso EP, Young WB, Shechter AL, Kaiser RS: Psychiatric comorbidity predicts outcome in chronic daily headache patients. Neurology 1999, 52:A471.Google Scholar
  38. 38.
    Guidetti V, Galli F, Fabrizi P, et al.: Headache and psychiatric comorbidity: clinical aspects and outcome in an 8-year follow-up study. Cephalalgia 1998, 7:455–462.CrossRefGoogle Scholar
  39. 39.
    Canestri P, Galli F, Tomaciello A, Guidetti V: Chronic daily headache in children and adolescents: a two years follow-up. Cephalalgia 2001, 4:288.Google Scholar
  40. 40.
    Radat F, Sakh D, Lutz G, et al.: Psychiatric comorbidity is related to headache induced by chronic substance use in migraineurs. Headache 1999, 39:477–480.PubMedCrossRefGoogle Scholar
  41. 41.
    Feinstein AR: The pre-therapeutic classification of comorbidity in chronic disease. J Chron Dis 1970, 23:455–468.CrossRefGoogle Scholar
  42. 42.
    Angold A, Costello JE, Erkanli A: Comorbidity. J Child Psychol Psychiat 1999, 40:57–87.PubMedCrossRefGoogle Scholar
  43. 43.
    Andrews G: Comorbidity and the general neurotic syndrome. Br J Psychiatry 1996, 168(suppl 30):76S-84S.Google Scholar
  44. 44.
    Andrasik A and Passchier J: Psychologic aspects. In The Headaches. Edited by Olesen J, Tfelt-Hansen P, Welch KMA. New York: Raven Press; 1993:489.Google Scholar
  45. 45.
    Peters JC: A treatise on headache. In Psychological Factors in Migraine. Edited by Blau JN. London: Chapmann and Hall; 1987:367–386.Google Scholar
  46. 46.
    Anstie FE: Neuralgia and disease that resemble it. In Migraine. Edited by Blau JN. London: Chapmann and Hall; 1987.Google Scholar
  47. 47.
    Liveing E: On Migraine, Sick-Headache, and Some Allied Disorders: A Contribution to the Pathology of Nerve Storms. London: J & A Churchill; 1978.Google Scholar
  48. 48.
    Moersch FP: Psychic manifestations in migraine. Am J Psychiatry 1924, 3:698–716.Google Scholar
  49. 49.
    Wolff HG: Personality features and reactions of subjects with migraine. Arch Neurol Psychiat 1937, 37:895.Google Scholar
  50. 50.
    Merikangas KR, Angst J, Isler H: Migraine and psychopathology: results of the Zurich cohort study of young adults. Arch Gen Psychiatry 1990, 47:849–853.PubMedGoogle Scholar
  51. 51.
    Breslau N, Davis GC, Andreski P: Migraine, psychiatric disorders, and suicide attempts: an epidemiological study of young adults. Psychiatry Res 1991, 37:11–23.PubMedCrossRefGoogle Scholar
  52. 52.
    Merikangas KR, Merikangas JR, Angst J: Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res 1993, 2:197–210.CrossRefGoogle Scholar
  53. 53.
    Merikangas KR: Psychopathology and headache syndromes in the community. Headache 1994, 34:S17-S26.PubMedCrossRefGoogle Scholar
  54. 54.
    Breslau N, Davis G: Migraine, physical health, and psychiatric disorder: a prospective epidemiologic study in young adults. J Psychiatr Res 1993, 2:211–221.CrossRefGoogle Scholar
  55. 55.
    Breslau N, Davis GC, Schultz LR, Peterson EL: Migraine and major depression: a longitudinal study. Headache 1994, 34:387–393.PubMedCrossRefGoogle Scholar
  56. 56.
    Breslau N, Schultz LR, Stewart LR, et al.: Headache and major depression: is the association specific to migraine? Neurology 2000, 54:308–313.PubMedGoogle Scholar
  57. 57.
    Glover V, Jarman J, Sandler M: Migraine and depression: biological aspects. J Psychiatr Res 1993, 2:223–231.CrossRefGoogle Scholar
  58. 58.
    Silberstein SD: Serotonin (5-HT) and migraine. Headache 1994, 34:408–417.PubMedCrossRefGoogle Scholar
  59. 59.
    Fasmer OB: The prevalence of migraine in patients with bipolar and unipolar affective disorders. Cephalalgia 2001, 21:894–899.PubMedCrossRefGoogle Scholar
  60. 60.
    Silberstein SD: Shared mechanisms and comorbidities in neurologic and psychiatric disorders. Headache 2001, 41(suppl1):11–17.CrossRefGoogle Scholar
  61. 61.
    Guitera V, Gutierrez E, Munoz P, et al.: Personality changes in chronic daily headache: a study in the general population. Neurologia 2001, 16:11–16.PubMedGoogle Scholar
  62. 62.
    Guitera V, Munoz P, Castillo J, Pascual J: Quality of life in chronic daily headache: a study in a general population. Neurology 2002, 58:1062–1065. This was the first study that analyzed the quality of life (QoL) in patients with chronic daily headache. It demonstrated reduced QoL aspects, most marked in patients with analgesic overuse. QoL was affected more by the chronicity than by the intensity of pain.PubMedGoogle Scholar
  63. 63.
    Puca F, Guazzelli M, Sciruicchio V, et al.: Psychiatric disorders in chronic daily headache: detection by means of the SCID interview. J Headache Pain 2000, 1:S33-S37.CrossRefGoogle Scholar
  64. 64.
    Juang KD, Wang SJ, Fuh JL, et al.: Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes. Headache 2000, 40:818–823.PubMedCrossRefGoogle Scholar
  65. 65.
    Verri AP, Cecchini P, Galli C, et al.: Psychiatric comorbidity in chronic daily headache. Cephalalgia 1998, 18(suppl 21):45–49.PubMedGoogle Scholar
  66. 66.
    Mitsikostas DD, Thomas AM: Comorbidity of headache and depression. Cephalalgia 1999, 19:211–217.PubMedCrossRefGoogle Scholar
  67. 67.
    Cerbo R, Prudenzano MP, Barbanti P, et al.: The importance of anxiety and depression as factors in chronicization of primary headaches. J Headache Pain 2000, 1:S45-S48.CrossRefGoogle Scholar
  68. 68.
    Arnstein P, Caudill M, Mandle CL, et al.: Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain 1999, 80:483–491.PubMedCrossRefGoogle Scholar
  69. 69.
    Verma S, Gallagher RM: The psychopharmocologic treatment of depression and anxiety in the context of chronic pain. Curr Pain Headache Rep 2002, 6:30–39.PubMedCrossRefGoogle Scholar
  70. 70.
    Gallagher RM, Verma S: Managing pain and comorbid depression: A public health challenge. Sem Clin Neuropsychiatry 1999, 4:203–220.Google Scholar
  71. 71.
    Blackburn-Munro G, Blackburn-Munro RE: Chronic pain, chronic stress and depression: coincidence or consequence. J Neuroendocrinol 2001, 13:1009–1023.PubMedCrossRefGoogle Scholar
  72. 72.
    Breslau N, Schultz LR, Stewart WF, et al.: Headache and major depression: is the association specific to migraine? Neurology 2000, 25;54:308–313.Google Scholar
  73. 73.
    Marcus DA: Identification of patients with headache at risk for psychologic distress. Headache 2000, 40:373–376.PubMedCrossRefGoogle Scholar
  74. 74.
    Breslau N, Schultz LR, Stewart WF, et al.: Headache types and panic disorder: directionality and specifity. Neurology 2001, 56:350–354. Shows evidence that migraine and other severe headaches are related to the presence of comorbid psychiatric disorders.PubMedGoogle Scholar
  75. 75.
    Juang KD, Wang SJ, Fuh JL, et al.: Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes. Headache 2000, 40:818–823.PubMedCrossRefGoogle Scholar
  76. 76.
    Firenze C, Prudenzano MP, Genco S, et al.: Personality factors in chronic headache: evaluation with SCL-90R. J Headache Pain 2000, 1:S53-S56.CrossRefGoogle Scholar
  77. 77.
    Cerbo R, Prudenzano MP, Barbanti P, et al.: The importance of anxiety and depression as factors in chronicization of primary headaches. J Headache Pain 1:S45-S48.Google Scholar
  78. 78.
    London LH, Shulman B, Diamond S: The role of psychometric testing and psychologic treatment in tension-type headache. Curr Pain Headache Rep 2001, 5:467–471.PubMedCrossRefGoogle Scholar
  79. 79.
    Lebovits AH: The psychologic assessment of patients with chronic pain. Curr Rev Pain 2000, 4122–126.Google Scholar
  80. 80.
    Holroyd KA, O’Donnell FJ, Stensland M, et al.: Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial. JAMA 2001, 285:2208–2215.PubMedCrossRefGoogle Scholar
  81. 81.
    Lake AE III: Behavioral and nonpharmacologic treatments of headache. Med Clin North Am 2001, 85:1055–1075.PubMedCrossRefGoogle Scholar
  82. 82.
    Rockicki LA, Holroyd KA, France CR, et al.: Change mechanisms associated with combined relaxation/EMG biofeedback training for chronic tension headache. Appl Psychophysiol Biofeedback 1997, 22:21–41.CrossRefGoogle Scholar
  83. 83.
    Larsson B, Andrasik F: Relaxation treatment of recurrent headaches in children and adolescents. In Headache and Migraine in Childhood and Adolescence. Edited by Guidetti V, Russell G, Sillanpää M, Winner P. London: Martin Dunitz; 2002:307–316.Google Scholar
  84. 84.
    Andrasik F, Larsson B, Grazzi L: Biofeedback treatment of recurrent headaches in children and adolescents. In Headache and Migraine in Childhood and Adolescence. Edited by Guidetti V, Russell G, Sillanpää M, Winner P. London: Martin Dunitz; 2002:307–316.Google Scholar
  85. 85.
    Redillas C, Solomon S: Prophylactic pharmacologic treatment of chronic daily headache. Headache 2000, 40:83–102.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2002

Authors and Affiliations

  • Vincenzo Guidetti
    • 1
  • Federica Galli
    • 1
  1. 1.Department of Child and Adolescent Neurology and PsychiatryInteruniversity Center for the Study of Headache and Neurotransmitter Disorders Section of Rome, University of Rome “La Sapienza,”RomeItaly

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