CHRONIC DAILY HEADACHE: MEDICATION OVERUSE AND PSYCHIATRIC MORBIDITY

  • Gupta Ravi Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Shahdara, Delhi (India)
  • Manjeet S, Bhatia Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Shahdara, Delhi(India) 
  • Chhabra Vishal Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Shahdara, Delhi(India) 

Abstract

Objectives: The objectives of the study were: (i) To assess the frequency of different chronic daily headaches in patients using ICHD-2 criteria (ii) To find out the frequency and type of medication overuse and
psychiatric morbidity in chronic daily headache subjects.
Design: Cross sectional observational study.
Place and duration of study: The study was conducted in the psychiatry outpatient department of a
teaching medical institution during January to September 2005.
Subjects and Methods: Subjects suffering from chronic daily headache were recruited from a specialized headache clinic in a tertiary care hospital’s Psychiatry department. The diagnoses were made according to ICHD-2. Medication overuse was defined according to ICHD-2 criteria and psychiatric illness
was diagnosed following ICD-10 criteria in CDH patients. In subjects fulfilling the criteria for ‘medication
overuse’, the culprit drug was stopped immediately and prophylactic therapy was started.
Results: Frequency of chronic daily headache was 37% in this sample. Females outnumbered males (1:
1.52) and formed higher number of migraine cases (p=0.02). Tension Type Headache (TTH) was most
frequent headache (48.5%). According to ICHD-2 criteria, probable medication overuse headache could
be diagnosed in all patients, which precluded the diagnosis of chronic migraine and chronic TTH.
Psychiatric morbidity was seen in 70.3% subjects and mild to moderate depression was the most
common illness (53%). TTH subjects showed predisposition for anxiety disorders (OR= 6.41; p= 0.004).
Conclusion: TTH is the most common subtype of CDH when ICHD-2 is followed. Medication overuse is
common in this group of patients and these probably should be discontinued according to substance
dependence de-addiction model for better compliance, and even more slowly in subjects with chronic
migraine headache. Psychiatric morbidity is prevalent in CDH patients and requires special attention.
Key words: Chronic Headache, Psychiatric morbidity, Treatment adherence, Analgesic overuse.

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Author Biographies

Manjeet S, Bhatia , Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Shahdara, Delhi(India) 
   
Chhabra Vishal, Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Shahdara, Delhi(India) 
   
Published
2007-06-30
How to Cite
1.
Ravi G, Bhatia MS, Vishal C. CHRONIC DAILY HEADACHE: MEDICATION OVERUSE AND PSYCHIATRIC MORBIDITY. J Pak Psychiatr Soc [Internet]. 2007Jun.30 [cited 2024Nov.22];4(01):19-4. Available from: https://jpps.pk/index.php/journal/article/view/732
Issue
Vol 4 No 01 (2007): Journal of Pakistan Psychiatric Society
Section
Original Article

Copyright © JPPS. Published by Pakistan Psychiatric Society

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