Prevalence of Major Depressive Disorder and Anxiety in Patients with Primary Headache

BACKGROUND Migraine is third most prevalent disorder and seventh-highest specific cause of disability worldwide. So also is the case with Major Depressive Disorder and anxiety which are growing in prevalence almost world over. In a psychiatry outpatient clinic, presentation of primary headache, major depressive disorder and anxiety are common. Various studies have found psychiatric co morbidities associated with various types of headache. Our study focuses on co existence of depression and anxiety in patients with primary headache. AIMS & OBJECTIVES To explore and establish co existence of headache with MDD or anxiety disorder or both, to categorize severity of MDD or anxiety disorder in patients with headache and to find out incidence of occurrence of MDD and anxiety disorder according to the type of headache. MATERALS & METHODS 100 outpatients presenting with primary headache were evaluated for depression and anxiety on HAM-D and HAM-A scales respectively over a period of 7 months. RESULTS The study found that out of 100 patients under the evaluation, that total 67 % of the subjects were having MDD (HAM-D - 7), out which 20.8 % subjects were having severe depression and 9 % were having very severe depression. Also, 59 % of subjects were having anxiety (HAMA - 14), out of which 47.4 % of subjects were having moderate anxiety and 23.7 % subjects were having severe anxiety. Also Tension type type headache was more associated with depression (41.7 %) and anxiety (54.3 %). Female patients were having more co morbidity than males. CONCLUSION Headache, MDD and anxiety co exist and hence require a detailed interview with appropriate application of scales for proper diagnosis and management.