One-third of adults presenting with headache report moderate depression symptoms

January 01, 0001

One-third of adults presenting with headache report moderate depression symptoms

This case-control study by researchers from Arizona was designed to determine whether adults who present to a primary care office with a chief complaint of headache have more reported symptoms of depression than adults presenting with other problems. Adult, English-speaking patients who presented to a primary care office with a chief complaint of headache were matched to adult patients of the same age and sex who presented with problems other than headache. All participants completed the PRIME-MD 9-item Patient Health Questionnaire as a screen for depression. A total of 200 participants entered the study. The mean age of the participants was 43.8 years. Women constituted 84% of the participants.

Of those patients who presented with headache, 32% had a likelihood of possible major depressive disorder compared with 12% in the patients presenting without headache.

The researchers concluded: "Almost one-third of adult patients who present to a primary care office with a complaint of headache report moderate symptoms of depression when screened compared with approximately 10% of patients presenting with a complaint other than headache. Given such a high prevalence of these symptoms, primary care physicians should screen all adult patients who present with headache for depression."

This means that there is a correlation between headaches and a PRIME MD score (which includes sleep disturbance and loss of energy) and may not be depression. This may not be causative in either direction, but each may have a common associated factor.

For the full abstract, click here.

The Journal of the American Board of Family Medicine 22 (6): 633-637, November 2009 © 2009 American Board of Family Medicine
Prevalence of Depression Symptoms in Outpatients with a Complaint of Headache. Robert A. Marlow, Cynthia L. Kegowicz and Kimberly N. Starkey. Correspondence to Robert A. Marlow: Robert A. Marlow [email protected]

Category: N. Neurological, P. Psychological. Keywords: headache, depression, prevalence, outpatients, PRIME MD, screening questionnaire, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 18 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.