Depression and anxiety in episodic and chronic cluster headache: A pilot study

Matthew S. Robbins, Rachel Bronheim, Richard B. Lipton, Brian M. Grosberg, Sarah E. Vollbracht, Fred D. Sheftell, Dawn C. Buse

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background. In contrast to migraine and tension-type headache, the psychiatric comorbidities of cluster headache (CH) have not been well-studied. Objective. We assessed the presence of depression and anxiety in groups of episodic CH (ECH) and chronic CH (CCH) patients and compared CH patients with and without depression and anxiety. Methods. Sociodemographics, comorbidities, and selected headache features were ascertained from a clinic-based sample in a cross-sectional fashion from January 2007 to July 2010. Active depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scales. Results. Of 49 CH patients, ECH patients (n = 32) had an earlier age of onset and consumed less caffeine than CCH patients (n = 17). Rates of depression as defined by a PHQ-9 score ge;10 were low in both ECH (6.3%) and in CCH (11.8%) with similar mean PHQ-9 scores (3.1 vs 3.7, P =.69). Rates of anxiety as defined by a GAD-7 score ge;10 were also low in both ECH (15.6%) and CCH (11.8%) with similar mean GAD-7 scores (3.8 vs 3.4, P =.76). ECH patients in and out of active attack periods had similar levels of depression and anxiety. Depression and anxiety usually occurred together in ECH and CCH patients. CH patients who were depressed or anxious were more likely to present at a younger age and have attack-related nausea and prodromal symptoms. Depressed CH patients were also more likely to have another pain disorder and had undertaken twice as many prophylactic medication trials. Conclusion. In this clinic-based cross-sectional study, ECH and CCH patients had similarly low rates of depression and anxiety. Rates were lower than those reported for both episodic and chronic migraine.

Original languageEnglish (US)
Pages (from-to)600-611
Number of pages12
JournalHeadache
Volume52
Issue number4
DOIs
StatePublished - Apr 2012

Fingerprint

Cluster Headache
Anxiety
Depression
Anxiety Disorders
Migraine Disorders
Comorbidity
Prodromal Symptoms
Tension-Type Headache
Somatoform Disorders
Caffeine
Age of Onset
Nausea
Headache
Psychiatry
Cross-Sectional Studies

Keywords

  • anxiety
  • chronic
  • cluster headache
  • comorbidity
  • depression
  • episodic

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

Depression and anxiety in episodic and chronic cluster headache : A pilot study. / Robbins, Matthew S.; Bronheim, Rachel; Lipton, Richard B.; Grosberg, Brian M.; Vollbracht, Sarah E.; Sheftell, Fred D.; Buse, Dawn C.

In: Headache, Vol. 52, No. 4, 04.2012, p. 600-611.

Research output: Contribution to journalArticle

Robbins, Matthew S. ; Bronheim, Rachel ; Lipton, Richard B. ; Grosberg, Brian M. ; Vollbracht, Sarah E. ; Sheftell, Fred D. ; Buse, Dawn C. / Depression and anxiety in episodic and chronic cluster headache : A pilot study. In: Headache. 2012 ; Vol. 52, No. 4. pp. 600-611.
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abstract = "Background. In contrast to migraine and tension-type headache, the psychiatric comorbidities of cluster headache (CH) have not been well-studied. Objective. We assessed the presence of depression and anxiety in groups of episodic CH (ECH) and chronic CH (CCH) patients and compared CH patients with and without depression and anxiety. Methods. Sociodemographics, comorbidities, and selected headache features were ascertained from a clinic-based sample in a cross-sectional fashion from January 2007 to July 2010. Active depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scales. Results. Of 49 CH patients, ECH patients (n = 32) had an earlier age of onset and consumed less caffeine than CCH patients (n = 17). Rates of depression as defined by a PHQ-9 score ge;10 were low in both ECH (6.3{\%}) and in CCH (11.8{\%}) with similar mean PHQ-9 scores (3.1 vs 3.7, P =.69). Rates of anxiety as defined by a GAD-7 score ge;10 were also low in both ECH (15.6{\%}) and CCH (11.8{\%}) with similar mean GAD-7 scores (3.8 vs 3.4, P =.76). ECH patients in and out of active attack periods had similar levels of depression and anxiety. Depression and anxiety usually occurred together in ECH and CCH patients. CH patients who were depressed or anxious were more likely to present at a younger age and have attack-related nausea and prodromal symptoms. Depressed CH patients were also more likely to have another pain disorder and had undertaken twice as many prophylactic medication trials. Conclusion. In this clinic-based cross-sectional study, ECH and CCH patients had similarly low rates of depression and anxiety. Rates were lower than those reported for both episodic and chronic migraine.",
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T1 - Depression and anxiety in episodic and chronic cluster headache

T2 - A pilot study

AU - Robbins, Matthew S.

AU - Bronheim, Rachel

AU - Lipton, Richard B.

AU - Grosberg, Brian M.

AU - Vollbracht, Sarah E.

AU - Sheftell, Fred D.

AU - Buse, Dawn C.

PY - 2012/4

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N2 - Background. In contrast to migraine and tension-type headache, the psychiatric comorbidities of cluster headache (CH) have not been well-studied. Objective. We assessed the presence of depression and anxiety in groups of episodic CH (ECH) and chronic CH (CCH) patients and compared CH patients with and without depression and anxiety. Methods. Sociodemographics, comorbidities, and selected headache features were ascertained from a clinic-based sample in a cross-sectional fashion from January 2007 to July 2010. Active depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scales. Results. Of 49 CH patients, ECH patients (n = 32) had an earlier age of onset and consumed less caffeine than CCH patients (n = 17). Rates of depression as defined by a PHQ-9 score ge;10 were low in both ECH (6.3%) and in CCH (11.8%) with similar mean PHQ-9 scores (3.1 vs 3.7, P =.69). Rates of anxiety as defined by a GAD-7 score ge;10 were also low in both ECH (15.6%) and CCH (11.8%) with similar mean GAD-7 scores (3.8 vs 3.4, P =.76). ECH patients in and out of active attack periods had similar levels of depression and anxiety. Depression and anxiety usually occurred together in ECH and CCH patients. CH patients who were depressed or anxious were more likely to present at a younger age and have attack-related nausea and prodromal symptoms. Depressed CH patients were also more likely to have another pain disorder and had undertaken twice as many prophylactic medication trials. Conclusion. In this clinic-based cross-sectional study, ECH and CCH patients had similarly low rates of depression and anxiety. Rates were lower than those reported for both episodic and chronic migraine.

AB - Background. In contrast to migraine and tension-type headache, the psychiatric comorbidities of cluster headache (CH) have not been well-studied. Objective. We assessed the presence of depression and anxiety in groups of episodic CH (ECH) and chronic CH (CCH) patients and compared CH patients with and without depression and anxiety. Methods. Sociodemographics, comorbidities, and selected headache features were ascertained from a clinic-based sample in a cross-sectional fashion from January 2007 to July 2010. Active depression and anxiety were assessed using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7-item (GAD-7) scales. Results. Of 49 CH patients, ECH patients (n = 32) had an earlier age of onset and consumed less caffeine than CCH patients (n = 17). Rates of depression as defined by a PHQ-9 score ge;10 were low in both ECH (6.3%) and in CCH (11.8%) with similar mean PHQ-9 scores (3.1 vs 3.7, P =.69). Rates of anxiety as defined by a GAD-7 score ge;10 were also low in both ECH (15.6%) and CCH (11.8%) with similar mean GAD-7 scores (3.8 vs 3.4, P =.76). ECH patients in and out of active attack periods had similar levels of depression and anxiety. Depression and anxiety usually occurred together in ECH and CCH patients. CH patients who were depressed or anxious were more likely to present at a younger age and have attack-related nausea and prodromal symptoms. Depressed CH patients were also more likely to have another pain disorder and had undertaken twice as many prophylactic medication trials. Conclusion. In this clinic-based cross-sectional study, ECH and CCH patients had similarly low rates of depression and anxiety. Rates were lower than those reported for both episodic and chronic migraine.

KW - anxiety

KW - chronic

KW - cluster headache

KW - comorbidity

KW - depression

KW - episodic

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