Psychiatric Disorders Common with Headache

By Worcester, Sharon | Clinical Psychiatry News, June 2007 | Go to article overview

Psychiatric Disorders Common with Headache


Worcester, Sharon, Clinical Psychiatry News


MIAMI BEACH -- Comorbid psychiatric conditions are common in patients with headache disorders, and can adversely affect the prognosis in patients with such disorders, Alvin E. Lake III, Ph.D., said at a symposium sponsored by the American Headache Society.

However, combined behavioral and drug therapy as well as patient education have been shown to improve outcomes, said Dr. Lake, director of the behavioral medicine division at the Michigan Headache and Neurological Institute, Ann Arbor.

Studies suggest that close to 50% of patients with chronic daily headache have an anxiety and/or mood disorder. In those with medication overuse headaches, the prevalence of mood and anxiety disorders appears to be even higher at 68%, according to one study.

Headache patients with psychiatric disorders also appear to have poorer long-term outcomes than do those with no psychiatric disorder. In one study, 57% of patients with multiple psychiatric disorders had worsening of their headaches over an 8-year period, compared with 7% of those with no psychiatric disorder. In addition, 29% of those with multiple psychiatric disorders experienced improvement, compared with 53% of those with no psychiatric disorder.

It appears that in most cases, the psychiatric disorders preceded the headache disorders. In a study of 41 patients with medication overuse headaches and comorbid psychiatric disorders, the psychiatric disorder preceded the headaches in 76% of those with a major depressive episode, 79% of those with panic disorder, 80% of those with generalized anxiety disorder, 89% of those with substance abuse disorder, and 100% of those with social phobia, Dr. Lake noted.

In addition to mood disorders, which have a genetic component, psychological factors, such as anticipatory fear of pain, and psychosocial factors, such as family and work pressures and a need to function, can drive excessive use of preemptive treatment, which in turn can lead to headache chronicity, he explained.

In one study of headache patients, the use of analgesics at initial assessment was associated with a relative risk of 19.6 for chronic daily headaches at 11-year follow-up, compared with a relative risk of 3.1 in those without analgesic overuse. Daily or weekly analgesic use also elevated the risk for chronic pain; in those who used analgesics more than 15 days per month, the relative risk of chronic migraine was 13.3 and the relative risk of nonmigraine headache was 6.2, compared with those without analgesic overuse.

Differential attention to the headache pain has been shown to modulate the subjective experience of pain, Dr.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Psychiatric Disorders Common with Headache
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.