ASSOCIATION OF DEPRESSION WITH HEADACHE

Abstract

Objectives: The objectives of the study were to find any association between depression and headache and assess the impact of depression on headache in terms of occurrence of headache its clinical profile and its subtypes. Design: Cross-sectional, clinic-based, observational study. Place and duration of study: The study was conducted in the psychiatry out-patient department of Guru Teg Bahadur Hospital, Delhi, India during December 2006 to July 2007. Subjects and Methods: Subjects suffering from depression and primary headaches were recruited from the psychiatry out-patient department. Depression was diagnosed using DSM-IV-TR criteria and depressed patients were assessed for the presence of headache. Headache in depressed patients and patients primarily with headaches was diagnosed using ICHD-2 criteria. Severity of depression was evaluated using Beck’s Depression Inventory-II. Patients who presented with both the disorders were inquired about the order of appearance of each disorder in time. Results: Amongst all patients with headache, 50% had depression and among all depressed patients, 42.4% complained of headache. The duration of headache was found to be shorter in depressed patients when compared to non-depressed patients (p = 0.002). Similarly frequency of headache was also found to be less in depressed subjects (p < 0.001) and same was the case with respect to duration of headache episode (p = 0.004). Conclusions: Headache is seen in moderate to severe depression only, and presence of depression is associated with milder headache. Headache sufferers develop only mild depression in due course. Depression does not predispose to development of a particular subtype of headache, suggesting similar pathophysiology among primary headaches. Key words: Depression, Headache, Beck’s Depression Inventory-II.