Psychiatric Comorbidity in Adolescents with Daily Headache (Chronic Daily Headache)

Background: Mental health problems of the adolescents represent an issue not only for mental health professionals but also for the people involved in their education, caregivers and members of families. In the case of comorbid association between mental health disorders and medical conditions the severity of both disorders is amplified and a multidisciplinary approach becomes a priority in order to offer the best possible outcome. Aims:Investigation of prevalence and correlation of comorbid psychiatric disorders in adolescents with chronic daily headaches (CDH). Method: In the study were included 61 adolescents, age 14-19 years old, with daily headache, identified by neurologist and diagnosed for CDH in accordance with the ICD 10 criteria. Patients underwent a detailed psychiatric interview by a child and adolescent psychiatrist and were assessed using Beck Depression Inventory and Hamilton anxiety scale. The data were processed statistically with SPSS statistics 21.0. Results and Discussion: 58 individuals (18M and 40F) competed the psychiatric evaluation. 24 subjects (47%) had more than one psychiatric disorder comorbid with major depression (21%) and with anxiety disorder (19%). Migraine associated with psychiatric disorders was frequently found compared with other primary headaches (odds ratio (OR) = 3.5, p = 0.002). Also psychiatric disorders were more frequent in the daily headaches over-utilization of analgesics. Conclusion: The high frequency of comorbid psychiatric disorders in CDH, and statistical significance leads to the recommendation that CDH is not only neurologist's domain. Psychiatric evaluation needs to be asked frequently for children suffering from chronic daily headaches.