ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH CHRONIC MIGRAINE AND CHRONIC TENSION-TYPE HEADACHE
DOI:
https://doi.org/10.32689/2663-0672-2024-4-3Keywords:
chronic migraine, chronic tension headache, anxiety, depression, painAbstract
Chronic migraine and chronic tension headache are among the most common types of primary headache that have a negative impact on daily activities and quality of life. In addition to headache symptoms, chronic types of headache are usually associated with the presence of psychopathological disorders, usually depression and anxiety. Anxiety and depression act as prognostic factors that worsen the course of chronic headache and predict a more pronounced impact of headache on daily life and functioning. Aim: to investigate the prevalence and characteristics of depressive and anxiety symptoms in patients with chronic migraine and chronic tension headache. Methods: clinical, neurological and neuropsychological examination of 79 people was conducted, including: 31 patients with chronic tension headache, 30 patients with chronic migraine (16 patients had migraine without aura, 14 with aura), as well as 18 patients from the control group who had no more than two episodes of headache in the last year. To determine anxiety and depression, the hospital anxiety and depression scale was used. To determine the quantitative and qualitative characteristics of pain, the visual analog pain scale and the McGill pain questionnaire were used. Results: the structure of the severity of anxiety and depression symptoms in patients with chronic migraine differed statistically significantly (p<0.05) from that in patients with chronic tension headache and the control group. The vast majority of patients in the control group and the group with chronic tension headache demonstrated a minimal degree of severity of anxiety symptoms. In contrast, the majority of patients with chronic migraine had a clinical degree of anxiety. Half of the patients with chronic migraine had subclinical or clinical depression, which distinguished them from other groups. A strong correlation between the hospital anxiety and depression scale and the visual analog pain scale was determined among all patients in the study. The severity of anxiety and depression was positively correlated with the subscales of the McGill Pain Questionnaire, in particular the sensorydiscriminative and motivational-affective components. Conclusions: anxiety and depression are more common in individuals with primary headache compared to those without headache. The prevalence of symptoms of depression and anxiety disorders in chronic migraine is higher than in chronic tension headache. The presence of symptoms of anxiety and depression affects the qualitative and quantitative characteristics of pain. The presence of clinically pronounced anxiety and depression increases the intensity of headache. The presence of aura in chronic migraine does not affect the level of anxiety and depression.
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