DEPRESSION AND ANXIETY IN PATIENTS WITH MIGRAINE AND TENSION-TYPE HEADACHE

Purpose: The identification of headache patients who are at risk for psy- chiatric comorbidity is an important quality of life and prognostic issue. The purpose of this study was to assess psychiatric comorbidity in TTH and migraine patients. Materials and Methods: The study group included 95 (75 female, 20 male) patients diagnosed with either migraine or TTH. All patients were requested to fill out a 44-item symptom list constructed according to DSM-IV diagnostic criteria for depression and anxiety disorders and to complete the Beck Depression Inventory (BDI) and Spielberger State-trait Anxiety Inventory (STAI). After that all patients were evaluated for the presence of psychiatric disorders according to DSM-IV criteria. Results: Fifty-one (53.7%) patients had migraine while 44 (46.3%) had TTH and their mean ages were 32.77±7.8 and 30.32±9.4 years, respecti- vely (p=0.11). The overall intensity levels of symptoms related to depressi- on and anxiety were similar in both migraine and TTH patients. However, reduced libido (p=0.02), slowness (p=0.04) and nausea (p=0.003) were more intense in migraine patients. The mean BDI, SAI and TAI scores were elevated to the pathologic range in both migraine and TTH patients despite the absence of a significant difference between the groups. The incidences of depression, anxiety and depression+anxiety were 37.3%, 15.7% and 9.8%, respectively, in migraine patients and 43.2%, 9.1% and 6.8%, respectively, in TTH patients (p=0.92). Conclusion: Depression and anxiety disorders are common and generally similar in extent and distribution in migraine and TTH patients. Key Words: Migraine, Tension-Type Headache, Anxiety, Depression. MIGREN VE GERILIM TIPI BASAĞRISINDA DEPRESYON VE ANKSIYETE Amac: Basagrisi olan olgularda psikiyatrik komorbidite riskinin belir- lenmesi olgularin yasam kalitesi ve prognostik acidan buyuk onem ta- simaktadir. Bu calismada migren ve gerilim tipi basagrisi (GTBA) olan hastalarda psikiyatrik bozukluklar arastirilmistir. Hastalar ve Yontem: Kirikkale Universitesi Tip Fakultesi Noroloji Ana- bilim dalinda ayrintili anamnez ve norolojik muayene sonunda ulusla- rarasi basagrisi kriterlerine gore migren ve gerilim tipi basagrisi tanisi alan 75 kadin, 20 erkek toplam 95 hasta calismaya alindi. Tum hastalara DSM-IV’de depresyon ve anksiyete bozukluklari tani kriterleri temel ali- narak hazirlanmis kirk bir soruluk bir semptom sorgulama formu verildi. Bununla birlikte hastalara Beck depresyon olcegi (BDO)ve durumluluk ve surekli anksiyete olcegi(STAI-t ve STAI-s) (Stait and trait) uygulan- di. Formlarin tamamlanmasini takiben olgulara psikiyatrik degerlendirme yapildi. Bulgular: Calisma grubunu olusturan olgularin 51’inde (%53.7) mig- ren ve 44’unde (%46.3) GTBA mevcut olup ortalama yaslari sirasiyla 32.77=7.8 ve 30.32=9.4 yil bulundu (p=0.11). Her iki grupta semptomlarin siddeti genel olarak benzer olmasina karsin migrenli olgularda libido azal- masi (p=0.02), yavaslik (p=0.04) ve bulanti’nin (p=0.003) daha agir oldu- gu goruldu. Gruplar arasinda fark olmamakla beraber hem migren hem GTBA’li olgularda BDO, STAI-t ve STAI-s skorlarinin patolojik derece- de yuksek oldugu belirlendi. Psikiyatrik degerlendirme sonrasinda mig- renli olgularin %37.3’unde depresyon, %15.7’sinde anksiyete, %9.8’inde depresyon+anksiyete birlikte saptanirken GTBA olgularin %43.2’sinde depresyon, %9.1’inde ankziyete, %6.8’inde depresyon+anksiyete birlikte bulunuyordu (p=0.92) Sonuc: Bu calismada hem migren hem GTBA’sinda yuksek oranda ve benzer siddette depresyon ve anksiyete komorbiditesi oldugu sonucuna varilmistir. Anahtar Sozcukler: Migren, Gerilim Tipi Basagrisi, Anksiyete, Depres- yon.