GREATER FREQUENCY OF DEPRESSION ASSOCIATED WITH CHRONIC PRIMARY HEADACHES THAN CHRONIC POST-TRAUMATIC HEADACHES

作者：McMurtray Aaron M^*; Saito Erin K; Diaz Natalie; Mehta Bijal; Nakamoto Beau

来源：International Journal of Psychiatry in Medicine, 2013, 45(3): 227-236.

DOI：10.2190/PM.45.3.b

• chronic pain
• depression
• headache

Objective: To compare the prevalence of co-morbid depression between patients with chronic primary headache syndromes and chronic post-traumatic 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%26apos;s Headache Classification criteria. Depression was determined through a combination of scores on the clinician administered Hamilton Rating Scale for Depression and patients%26apos; 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 %26lt; 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 %26lt; 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.

• 出版日期2013