Published: 2016-12-19

Prevalence of psychiatric co-morbidity in patients presenting with chronic daily headache: a hospital based cross sectional study

Bhuvana R. C.


Background: Headache is a common neurological disorder and most disabling conditions in the worldwide. Psychiatric disorders can occur with at least two to three-fold greater frequencies among the patients presenting with headache than among general population. The presence of psychiatric co-morbidity further complicates headache management and portends a poorer prognosis. Therefore, the present study of prevalence of psychiatric co-morbidity in patients presenting with headache and to know the nature and extent of psychiatric co-morbidity associated with headache among the patients was undertaken.

Methods: Present sample consists of 100 patients who presented with the complaints of headache to the department of Psychiatry and Medicine from November 2012 to June 2014 was included in the study. MINI 5.0.0 was applied to elicit the presence of any Axis I and Axis II disorders respectively.

Results: In this study 74% of the patients presenting with headache had co-morbid psychiatric disorders. Out of 74% of the psychiatric illnesses; 28% had affective spectrum disorders, 16% had anxiety disorders 16% had psychotic disorders, 12% had other neurotic stress related disorders, and 2% had personality disorder among the patients presenting with headache.

Conclusions: Patients presenting with headache have high levels of co-morbid psychiatric disorders and the presence of headache in these patients was associated with increased severity of the co-morbid psychiatric conditions. In view of the present findings, the management of patients presenting with headache should include the detail assessment of coexisting psychopathology and treatment of both coexisting conditions.


Chronic daily headache, Cluster-type headache, Migraine, Psychiatric co-morbidity, Tension-type headache

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Hussain AAM, Mohit MA, Ahad MA, Alim MA. A Study on Psychiatric Co-morbidity among the Patients with Migraine. TAJ. 2008;21(2):108-11.

Amanda K, Kathleen M. Physical and Mental Comorbidity of Headache in a Nationally Representative Sample of U.S. Adults. Psychosom Med. 2008;70(7):773-80.

Zuraida NZ, Parameswaran R. Prevalence of Depression among Patients with Headache in Kuala Lumpur, Malaysia. Malaysian J Psych. 2007;16(2).

Lake AE, Rains JC, Penzien DB, Lipchik GL. Headache and psychiatric comorbidity: Historical context, clinical implications and research relevance. Headache. 2005;45:493-506.

Antonaci F, Nappi G, Galli F, Manzoni GC, Calabresi P, Costa A. Migraine and psychiatric comorbidity: a review of clinical Findings. J Headache Pain. 2011;12:115-25.

Lipton RB, Mansur H. Headache, study of 3350 cases. Bangladesh J Neuroscience. 2001;17(1):1-5.

Mansur, Jain AP, Chauhan B, Bhat AD. Sociodemographic and Clinical Profile of Headache –A Rural hospital-based study. IACM. 2007;8(1):26-8.

Tan HJ, Suganthi C, Dhachayani S, Rizal AM, Raymond AA. The coexistence of anxiety and depressive personality traits in migraine. Singapore Med J. 2007;48(4):307.

Stovner LJ, Andree C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain. 2010;11(4):289-99.

Kandil MR, Hamed SA, Fadel KA, Youssef AH, Mohammed AB, Hamed et al. Epidemiology of tension-type headache (TTH) in Assuit Governorate, Egypt.Journal of neurology and neuroscience. 2014;5(1):2.

Bera SC, Sudhir K, Sood KM, Goyal V. A comparative study of psychiatriccomorbidity, quality of life and disability in patients with migraine and tensiontype headache. Neurology India. 2014;(62)5.

Singh AK, Shukla R, Trivedi JK, Singh D. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population. J Neurosci Rural Pract. 2013;4:132-9.

Verri AP, Cecchini PA, Galli C, Granella F, Sandrini G, Nappi G. Psychiatric comorbidity in chronic daily headache. Cephalalgia. 1998;18(21):45-9.

Filippis D, Teixeira AL, Costa EAC, Silva Jr AAD, Moreira dos Santos A, Go´mez RS, Kummer A, et al. Psychiatric comorbidities of chronic migraine in community and tertiary care clinic samples. J Headache Pain. 2012;13:551-5.

Merikangas M, Mateen FJ, Dua1 T, Steiner T, Saxena S. Headache disorders in developing countries: research over thepast decade. Cephalalgia. Inter J Headache. 2008.