Anxiety disorder, depression and chronic daily headache: a case-control study.

Chronic headache cause high disability in sufferers and high social cost. Data regarding possible comorbid diseases, manly depression and anxiety, are still few and conflicting.The aim of this case-control, hospital-based study was: to evaluate the prevalence of depression and anxiety in subjects with chronic migraine (CM) and chronic tension-type headache (CTTH); and to compare the results with those found in a control group without headache. Materials and methods We studied 79 patients, 46 with CM and 33 with CTTH, consecutively referred to the Adult Headache Centre of the University of Palermo (A.H. Study) between 2007 and 2009, and 316 controls without headache (each patient was matched by sex and age to four controls).The headache diagnosis was established according to the ICHD-II criteria. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HAD). Results Mean age was 47.6 years (±17.8 yrs) for the 79 patients with chronic headache (66 F, 13 M) and 47.6 years (±17.8 yrs) for the 316 controls (264 F, 52 M). The mean HAD-D score was 8.6±4.3 in the chronic headache group and 7.0±3.5 in the control group; ( p=0.00). The mean HAD-A score was 11.2±4.5 in the chronic headache group versus 9.0 ± 3.7 in the control group. Following multiple logistic regression analysis, the presence of depression and anxiety was associated with chronic headache (depression: OR=2.2, 95% CI 1.2-4.1; anxiety: OR=2.4, 95% CI 1.3-4.3). Conclusion. According to our data, anxiety and depressive symptoms are more prevalent in chronic headache, and correlate to an increased risk of chronic headache.