Accompanying symptoms and psychiatric comorbidity in migraine and tension-type headache patients

OBJECTIVE: Our objective was to assess the prevalence of accompanying symptoms of migraine and tension-type headache in patients with such conditions (both episodic and chronic) and in headache-free controls, and their relationship with depression and anxiety. METHOD: A psychological assessment (Axis I, DSM-IV) was performed, and 21 accompanying symptoms were investigated in 506 patients with episodic migraine (231), chronic migraine (102), episodic tension-type headache (83), and chronic tension-type headache (90) and in 80 controls. The relationship between symptoms, headache type, and psychiatric comorbidity was analyzed. RESULTS: The mean number of symptoms was significantly higher in patients (n=10.3) than in controls (n=3.4). Most symptoms were significantly associated with depression and anxiety, while only some of them were significantly associated with headache, with no relevant difference among groups. CONCLUSION: In headache patients, psychiatric comorbidity (compared with headache type or chronicity) seems to be more strictly associated with an increased burden of accompanying symptoms.