Headache and major depression: is the association specific to migraine?
ABSTRACT To examine the relationship between migraine and major depression, by estimating the risk for first-onset major depression associated with prior migraine and the risk for first migraine associated with prior major depression. We also examined the extent to which comorbidity with major depression is specific to migraine or is observed in other severe headaches.
Representative samples of persons 25 to 55 years of age with migraine or other severe headaches (i.e., disabling headaches without migraine features) and controls with no history of severe headaches were identified by a telephone survey and later interviewed in person to ascertain history of common psychiatric disorders.
Lifetime prevalence of major depression was approximately three times higher in persons with migraine and in persons with severe headaches compared with controls. Significant bidirectional relationships were observed between major depression and migraine, with migraine predicting first-onset depression and depression predicting first-onset migraine. In contrast, persons with severe headaches had a higher incidence of first-onset major depression (hazard ratio = 3.6), but major depression did not predict a significantly increased incidence of other severe headaches (hazard ratio = 1.6).
The contrasting results regarding the relationship of major depression with migraine versus other severe headaches suggest that different causes may underlie the co-occurrence of major depression in persons with migraine compared with persons with other severe headaches.
Article: Cefalea (II). Migraña[Show abstract] [Hide abstract]
ABSTRACT: Migraine is the second most common primary headache after tension headaches. Sometimes cause significant alteration of the quality of life of sufferers. Diagnosis and treatment of the crisis abortive and prophylactic treatment of them is essential. For proper management will have to individualize treatment depending on age, sex and other comorbidities experienced by the migraine sufferer. The treatment of migraine attacks and prophylactic, should be applied to the required dose or in synergistic combinations, to improve effectiveness and prevent side effects. For handling not only drug treatment will be considered, but also the avoidance of triggers or enhancers factors. There are certain types of migraines less frequent occurrence, but if you do not think they can make the patient suffer wrong, and even dangerous treatment unneccesary and request unnecessary tests. Always before a migraine sufferer will have to make an accurate medical history and neurological examination to detect signs or warning signs that make us a test of neuroimaging or referral to a neurologist.01/2015; 11(70):4155-4166. DOI:10.1016/S0304-5412(15)70894-2
[Show abstract] [Hide abstract]
ABSTRACT: Amaç: Aurasýz migren (AM) ile epizodik gerilim tipi baþaðrýsý (EB), benzer klinik özelliklere sahip ve sýk-lýkla ayrýcý taný güçlüðünün izlendiði baþaðrýlarýdýr. Her iki tür baþaðrýsýnda da psikiyatrik problemlerin varlýðý bilinmektedir. Bu çalýþmada, AM ve EB tanýsý almýþ olgulara ait klinik özelliklerin, psikiya-trik problemlerle birliktelikleri ve eþlik eden ayrýcý özelliklerin deðerlendirilmesi amaçlandý. Gereç ve Yöntem: Kartal Araþtýrma ve Eðitim Hastanesi Nöroloji polikliniðine baþvuran ve daha önce hiçbir psikiyatrik taný ve yardým almamýþ 45 hasta çalýþmaya dahil edildi. Baþaðrýsý tanýsý, 2004 Uluslararasý Baþaðrýsý Birliði tarafýndan oluþturu-lan kriterlere göre konuldu. AM ve EB tanýlarýný almýþ olgularda eþlik eden psikiyatrik problemlerin varlýðý ve ayrýcý taný özelliklerinin deðerlendirilmesi için, Geniþletilmiþ Kýsa-Uluslararasý Nöropsiki-yatrik Görüþme 5.0.0 (MÝNÝ PLUS) adlý yapý-landýrýlmýþ psikiyatrik görüþme, Hamilton Depresyon Ölçeði (HAM-D) ve Migren Yeti Yitimi Deðerlendirme Ölçeði (MÝDAS) kullanýldý. Hastalarýn baþaðrýsýný algýlama þiddetlerini belirleyebilmek için, Görsel Deðerlendirme Ölçeði (Visual Analog Scale VAS) uygulandý. Veriler SPSS 10.0 isimli istatistik paket programý ile bilgisayar ortamýnda deðerlendirildi. Bulgular: EB hastalarýnýn tümüne psikiyatrik taný konulurken, AM hastalarýnýn %41,4'üne ek psikiya-trik taný konuldu. Ruhsal uyaranlarla tetiklenme, kendiliðinden aðrý kesici kullanýmý, hastalýðýn baþlangýcýndan önceki üç ay içinde psikososyal stresör varlýðý, AM ile kýyaslandýðýnda EB'de istatis-tiksel olarak anlamlý derecede daha fazlaydý (p<0,05). AM türü baþaðrýsýnýn, menses ile iliþkisi ve fizyolojik uyaranlarla tetiklenmesi, EB'na kýyasla istatistiksel olarak anlamlý derecede daha fazlaydý (p<0,05). EB hastalarýnýn MÝDAS skoru daha yük-sekti ve bu farklýlýk istatistiksel olarak anlamlýydý (p<0,05). Sonuç: EB ile psikiyatrik hastalýklar daha yüksek oranda bir arada bulunmakta ve baþaðrýsýna baðlý yeti yitimi EB'de daha yüksektir. Baþaðrýlarý ve psikiyatrik bozukluklar arasýndaki iliþkiyi ortaya koyan yeterli sayýda çalýþma olmamasý; baþaðrýsý tanýsý konulurken psikiyatrik bozukluklarýn yarata-caðý ek yükle taný karýþýklýðýna yol açmaktadýr. Bu nedenle ayrýcý taný zorluðu yaþanan baþaðrýlý hasta-lara yapýlandýrýlmýþ psikiyatrik muayenenin uygu-lanmasý; aðrýya baðlý yeti yitiminin, EB hastalarýnda da deðerlendirilmesinin önemli olduðu ve tedavi protokolünün düzenlenmesi açýsýndan ayrýcý tanýnýn ihmal edilmemesi gerektiði düþünüldü. Anahtar kelimeler: Aurasýz migren, epizodik gerilim tipi baþaðrýsý, psikiyatrik bozukluk, yeti yitimi
[Show abstract] [Hide abstract]
ABSTRACT: Migraine has close associations with depression and anxiety. Catastrophizing, an alarmist reaction to pain, has been proposed as one of the mediators in the relationship between headache and emotional distress. However, much experimental evidence is needed to make such a view more validated. The aims of this study are to examine the effects of mood induction on the pain responses and to investigate the role of pain catastrophizing in the relationship between pain and mood amongst a sample of patients with migraine. For this purpose, 60 patients with migraine were recruited from a headache clinic in Tehran-Iran and were randomly assigned into one of three groups: negative mood induced group, positive mood induced group and control group. The following instruments and measures were used in this study: mood induction by presenting different types of films (positive, negative), a computerized cognitive task to elicit pain, Beck Depression Inventory and Pain Catastrophizing Scale. The results showed that while the induction of depressed mood increased the pain intensity, the induction of positive mood reduced it significantly (p < 0.05). Further analyses revealed that catastrophizing is as a confounding factor in the relationship between pain and mood. Once catastrophizing scores were entered into the analyses as a covariate, the significant effect of mood on the pain intensity reduced. In conclusion, both mood and catastrophizing are important factors in understanding the migraine pain. Clinical implications of these findings are discussed in the paper. Copyright © 2014 John Wiley & Sons, Ltd.Key Practitioner MessagePain-related catastrophizing and mood induction are important factors in understanding pain intensity amongst patients with migraine pain.Catastrophizing as a confounding factor in the relationship between pain and mood may partially mediate the relationship between mood and pain.Therapeutic interventions should focus on the reduction of depression and catastrophizing.Clinical Psychology & Psychotherapy 12/2014; DOI:10.1002/cpp.1939 · 2.59 Impact Factor