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Original Article
4 (
2
); 132-139
doi:
10.4103/0976-3147.112736

Association of psychiatric co.morbidity and efficacy of treatment in chronic daily headache in Indian population

Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Gomti Nagar, India
Departments of Neurology, Chhatrapati Shahuji Maharaj Medical University (Erstwhile King George’s Medical University), Lucknow, Uttar Pradesh, India
Departments of Psychiatry, Chhatrapati Shahuji Maharaj Medical University (Erstwhile King George’s Medical University), Lucknow, Uttar Pradesh, India
Address for correspondence: Dr. Ajai Kumar Singh Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences Vibhuti Khand‑2, Gomti Nagar, Lucknow ‑ 226 010, Uttar Pradesh India ajai.shreshtha@gmail.com
Licence
This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Disclaimer:
This article was originally published by Thieme Medical and Scientific Publishers Private Ltd. and was migrated to Scientific Scholar after the change of Publisher.

Abstract

ABSTRACT

Objective: To study the prevalence of psychiatric co‑morbidity in patients of chronic daily headache (CDH) and compare the efficacy of treatment between various type of headache associated with psychiatric co‑morbidity. Materials and Methods: Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI) scale at the time of enrolment and at 3 months. Results: CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM) accounted for 59 patients, chronic tension type headache (CTTH) 22 patients, new daily persistent headache (NDPH) 3 patients and miscellaneous 8 patients. Psychiatric co‑morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7%) as compared to CTTH (36.4%). Single psychiatric co‑morbidity was seen in 26 patients, while 23 patients had multiple co‑morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co‑morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients. Conclusion: Psychiatric co‑morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.

Keywords

Chronic daily headache
chronic migraine
chronic tension type headache
psychiatric co.morbidity

Conflict of Interest

None declared

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