The high level of psychiatric disorders associated with migraine or tension-type headache in adolescents

Background: Headache is the most common medical disorder with a lifetime prevalence of over 90% . Headache is commonly associated with psychiatric syndromes where psychiatrists are often consulted for the evaluation and treatment of people suffering from it. Aim: To study the clinical patterns and psychiatric co-morbidity of the patients suffering from headache attending to department of psychiatry in a general hospital. Methodology: After prior consent, Socio-demographic details and the clinical details of the headache were collected and the diagnosis of the headache was coded using ICHD. Psychiatric diagnosis was made using ICD-10 with the help of consultant. Results: Majority of the subjects (69.1%) presented with primary headache. Tension type headache (49.1%) was the most common type of headache followed by migraine (18.2%). Secondary headaches were seen in 30.9% of individuals. Conclusion: Headache is commonly co-morbid with psychiatric disorders. Early identification of psychiatric disorders helps in proper management and treatment of the individuals with headache.

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Tension-type headache as most frequent and often erroneous diagnosis

Medical alphabet ◽

10.33667/2078-5631-2020-11-5-9 ◽

2020 ◽

Vol 1 (11) ◽

pp. 5-9

Author(s):

E. G. Filatova ◽

D. M. Merkulova

Keyword(s):

Behavioral Therapy ◽

Primary Headache ◽

Preventive Therapy ◽

Tension Type Headache ◽

Level Of Evidence ◽

Erroneous Diagnosis ◽

Similar Phenotype ◽

Acute Attacks ◽

Type Headache ◽

High Level

Tension-type headache (ТТН) is the most frequent and at the same time the most difficult to diagnose type of primary headache. The clinical features of TTH are nonspecific, and a similar phenotype can be observed in migraines with a relatively mild course, psychogenic headache, and secondary headaches. Often associated with a misdiagnosis is treatment failure. Three generally accepted approaches to therapy are presented in the article: behavioral therapy, acute treatment that have a high level of evidence on the basis of randomized controlled trials, as well as preventive therapy. The place of ketoprofen was determined, including various dosage forms of the drug – injectable, oral (tablets, powders, capsules), which allows it to be used to quickly and effectively relieve acute attacks of TTH.

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Comorbilidades Psiquiátricas Associadas às Cefaleias: a Experiência da Consulta de Ligação

Acta Médica Portuguesa ◽

10.20344/amp.5541 ◽

2015 ◽

Vol 28 (1) ◽

pp. 44

Author(s):

Vera Martins ◽

José Temótio ◽

Ilda Murta

Keyword(s):

Psychiatric Disorders ◽

Multidisciplinary Approach ◽

Clinical Situation ◽

Tension Type Headache ◽

Cognitive Behavioral Intervention ◽

Multidisciplinary Intervention ◽

Psychopharmacological Treatment ◽

Type Headache ◽

Clinical Records ◽

Clinical Conditions

Introduction: The comorbidity between headaches and psychiatric disorders is common and may be explained by different mechanisms in terms of uni or bi-directional models, or sharing of genetic and environmental risk factors relating to development of both clinical conditions. The presence of this comorbidity has important implications for patients with headaches and for patients with psychiatric disorders, worsens the clinical situation, increases the risk of chronicity, the pain intensity and the rate of treatment failure. Material and Methods: The authors performed a descriptive, retrospective study of prevalence, involving 250 patients seen in Psychiatry - Headaches liaison consultation, over a period of 3 years, from July 1, 2011 to July 1, 2013. The authors undertook the analysis of the clinical records, in respect to sociodemographic and clinical data, neurological and psychiatric diagnosis and prescribed therapy. Results and Discussion: During this period were made 689 liaison consultations, with a prevalence of female patients (84%) and a mean age of 47 years. The tension type headache (60.8%), migraine (24.8%) and headache attributed to psychiatric disorders (7.2%) were the most prevalent types of headaches. Mood disorders (62%) and neurotic stress related disorders (39.2%) were the most frequent psychiatric diagnoses. The therapeutic intervention in these cases emphasizes the multidisciplinary approach with the collaboration of Neurologist and Psychiatrist, based in psychoeducation, cognitive-behavioral intervention and psychopharmacological treatment. Conclusion: Given the complexity of the clinical picture in cases of comorbidity, the experience of psychiatry liaison consultation and multidisciplinary intervention has proved particularly valuable in treating these patients, configuring itself as the proper treatment of this comorbidity. Keywords: Comorbidity; Headache; Mental Disorders; Psychiatry.

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Headache and fibromyalgia

Oxford Textbook of Headache Syndromes ◽

10.1093/med/9780198724322.003.0058 ◽

2020 ◽

pp. 523-529

Author(s):

Marina de Tommaso ◽

Vittorio Sciruicchio

Keyword(s):

Chronic Headache ◽

Sleep Disturbances ◽

Early Recognition ◽

Pain Syndrome ◽

Paediatric Population ◽

Tension Type Headache ◽

Muscle Tenderness ◽

Type Headache ◽

High Level ◽

Evidence Based Guidelines

Fibromyalgia (FM) is a chronic pain syndrome that is associated with a high level of disability and medical costs. FM is commonly comorbid with migraine and tension-type headache, and is also associated with sleep disturbances, anxiety, and pericranial muscle tenderness Fibromyalgia may be caused by central sensitization, which is also believed to be an important mechanism in the development of chronic headache. Fibromyalgia remains underdiagnosed in the paediatric population, while the early recognition of this syndrome would improve the efficacy of therapy. There are presently no evidence-based guidelines for the pharmacological and non-pharmacological treatment of headache patients with comorbid FM. Amitriptyline has been reported to be efficacious in in migraine, tension-type headache, and fibromyalgia independently, but evidence regarding comorbid headache and fibromyalgia is lacking. Non-pharmacological approaches that have shown promise in patients with chronic migraine and fibromyalgia include transcranial electric and mechanical stimulation.

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Psychiatric Comorbidity and Psychosocial Stress in Patients with Tension-Type Headache From Headache Centers in Italy

Cephalalgia ◽

10.1046/j.1468-2982.1999.1903159.x ◽

1999 ◽

Vol 19 (3) ◽

pp. 159-164 ◽

Cited By ~ 39

Author(s):

F Puca ◽

S Genco ◽

MP Prudenzano ◽

M Savarese ◽

G Bussone ◽

...

Keyword(s):

Psychiatric Disorders ◽

Psychosocial Stress ◽

Depressive Disorders ◽

Psychiatric Comorbidity ◽

Somatoform Disorders ◽

Systematic Investigation ◽

Tension Type Headache ◽

Psychiatric Interview ◽

Ihs Classification ◽

Type Headache

A multicenter study was carried out in 10 Italian Headache Centers to investigate the prevalence of psychosocial stress and psychiatric disorders listed by the IHS classification as the “most likely causative factors” of tension-type headache (TTH). Two hundred and seventeen TTH adult outpatients consecutively recruited underwent a structured psychiatric interview (CIDI-c). The assessment of psychosocial stress events was carried out using an ad hoc questionnaire. The psychiatric disorders that we included in the three psychiatric items of the fourth digit of the IHS classification were depressive disorders for the item depression, anxiety disorders for the item anxiety, and somatoform disorders for the item headache as a delusion or an idea. Diagnoses were made according to DSM-III-R criteria. At least one psychosocial stress event or a psychiatric disorder was detected in 84.8% of the patients. Prevalence of psychiatric comorbidity was 52.5% for anxiety, 36.4% for depression, and 21.7% for headache as a delusion or an idea. Psychosocial stress was found in 29.5% of the patients and did not differ between patients with and without psychiatric comorbidity. Generalized anxiety disorder (83.3%) and dysthymia (45.6%) were the most frequent disorders within their respective psychiatric group. The high prevalence of psychiatric disorders observed in this wide sample of patients emphasizes the need for a systematic investigation of psychiatric comorbidity aimed at a more comprehensive and appropriate clinical management of TTH patients.

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Examination of anxiety, hostility and psychiatric disorders in patients with migraine and tension-type headache

International Journal of Clinical Practice ◽

10.1111/j.1368-5031.2005.00522.x ◽

2005 ◽

Vol 59 (5) ◽

pp. 515-521 ◽

Cited By ~ 22

Author(s):

B. Bag ◽

R. Hacihasanoglu ◽

F. G. Tufekci

Keyword(s):

Psychiatric Disorders ◽

Tension Type Headache ◽

Type Headache

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Personality and Response To Repeated Visual Stimulation in Migraine and Tension-Type Headaches

Cephalalgia ◽

10.1046/j.1468-2982.1999.019008718.x ◽

1999 ◽

Vol 19 (8) ◽

pp. 718-724 ◽

Cited By ~ 45

Author(s):

W Wang ◽

G-P Wang ◽

X-L Ding ◽

Y-H Wang

Keyword(s):

Sensation Seeking ◽

Visual Stimulation ◽

Tension Type Headache ◽

Short Term ◽

Short Period ◽

Type Headache ◽

High Level ◽

Tension Type Headaches ◽

The Brain

Migraine sufferers potentiate their visual evoked potentials (VEPs) from a short period of 2 min to a longer period of 15 min. As a lack of habituation is linked to higher level arousal, we thus hypothesized that short-term VEP potentiation might be correlated with an arousal-related personality trait. We therefore carried out short-term VEPs, Plutchik-van Praag's Depression Inventory, Zuckerman's Sensation-Seeking Scales (Form V), and Zuckerman-Kuhlman's Personality Questionnaire in 26 healthy subjects, 22 patients suffering from migraine without aura between attacks, 13 episodic and 20 chronic tension-type headaches. The chronic tension-type headache sufferers showed increased depression compared with other groups, which might be a consequence of the headache itself. Migraines, however, showed steeper habituation slopes of N1-P1 and P1-N2, decreased thrill and adventure-seeking, and general sensation-seeking man healthy controls; in addition, the habituation slope of P1-N2 was positively correlated with experience-seeking in migraine. The short-term VEP potentiation and the decreased thrill and adventure-seeking and general sensation-seeking in migraine might be related to a high level of cortical arousal and a low 5HT neurotransmission. In compliance with the long-term VEP study, the positive correlation between the P1-N2 habituation slope and experience-seeking in migraine suggests a continuous metabolic overload for the brain interictally, which can trigger the activation of a migraine attack.

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Tension-type headache in patients with concomitant musculoskeletal disorders

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-3-4-72-79 ◽

2020 ◽

pp. 72-79

Author(s):

Yu. O. Novikov ◽

I. E. Salakhov

Keyword(s):

Cervical Spine ◽

Drug Therapy ◽

Drug Treatment ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Tension Type Headache ◽

World Health ◽

Standard Drug ◽

Rehabilitation Treatment ◽

Type Headache

Introduction. According to the defi nition of the World Health Organization (WHO), tension-type headache (TTH) is the most common type of primary headache. Rehabilitation of patients with chronic tension-type headache continues to be an important socio-medical problem. Its main goal is the most complete restoration of the functions of the musculoskeletal system of the neck, the correction of vascular and psychoemotional problems, and the patient′s return to his everyday life and work. As a rule, the main emphasis in the treatment of such patients is placed primarily on drug therapy. At the same time, practitioners are faced with a number of problems — the low effectiveness of the treatment, the nonpersistency of the results, allergic reactions, polypharmacy and others. All this suggests that there is a need for differentiated rehabilitation treatment of patients with tension-type headache with the use of various non-pharaceutical methods. The goal of research — to evaluate the clinical effi cacy of complex non-drug therapy in patients with tension-type headache.Materials and methods. The prospective controlled randomized study, which was conducted from October 2017 to March 2019 at the Department of Medical Rehabilitation of the Bashkir State Medical University, included 110 patients with TTH from the age of 20 to 45 years. All patients, depending on the treatment methodology used, were randomly divided into two groups of 55 people. Patients of the main group received complex rehabilitation treatment with the use of non-drug methods: osteopathic correction, acupuncture and exercise therapy. Patients in the control group received treatment in accordance with the standard of medical care for TTH (analgesics, non-steroidal antiinfl ammatory drugs, antidepressants, vasoactive and nootropic drugs). The study of the clinical effectiveness of the therapy included: an assessment of the severity of pain with the use of a visual analogue scale and a tensoalgimeter, a goniometric study with an assessment of the volume of active movements in the cervical spine, transcranial ultrasound dopplerography with an assessment of quantitative indicators in the system of the middle cerebral artery.Results. The use of complex non-drug therapy in patients with TTH compared with standard drug therapy leads to a signifi cantly more important decrease in the severity of pain, an increase in pain threshold, an increase in the volume of active movements in the cervical spine. The effect of non-drug treatment methods on blood fl ow in the system of the middle cerebral artery is comparable in its effectiveness with the use of pharmaceutical drugs.Conclusion. The proposed complex rehabilitation treatment of patients with TTH with the use of non-drug methods has shown clinical effi cacy which is comparable, and in a number of indicators, superior to the effectiveness of conventional medical treatment. All this determines the necessity of wider implementation of multidisciplinary non-drug treatment of patients with this pathology.

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