Headache in psychiatric patients

Abstract

Background and aims:

The association between headache and psychiatric disorders is formally acknowledged. Although the majority of headaches represent comorbidity (perhaps reflecting a common biological substrate) there is increasing evidence of a bi-directional relationship linking somatic conditions and psychopathology.

The International Headache Society (IHS) classifies in the International Classification of Headache Disorders – ICDH-2 (2004) two main types of Headache Attributed to Psychiatric Disorder, distinguishing between headaches associated with Somatisation Disorders and Psychotic Disorders.

Headache attributed to psychiatric disorder is a diagnosis reserved for when it occurs not as a primary disorder, but as a symptom, or as causally related to the psychiatric disorder.

The authors intend to study the distribution os headaches in a psychiatric population.

Methods:

To a population of hospitalized psychiatric patients, able to communicate verbally and consenting to be interviewed, was applied a questionnaire used and validated by the Portuguese Headache Society for population studies. Medical records were also revised in order to access tne mental diagnosis ICD-10.

Conclusions:

In this population, headaches are a frequent complaint, mainly in females. Regardless of the mental diagnosis, the prevailing are tension-type headache. In Schizophrenic patients, we did not find migraine and there was a higher percentage of patients without headache. Despite the high prevalence of headache in the psychiatric population, headaches attributed to Psychiatric disorders are rare.