THE ASSOCIATION BETWEEN MAJOR DEPRESSION AND HEADACHE - RESULTS OF A LONGITUDINAL EPIDEMIOLOGIC-STUDY IN YOUTH

Retrospective epidemiologic research in adults suggests that a long-te rm association between major depression and headache arises during chi ldhood or adolescence. This study uses data from a prospective epidemi ologic study to examine the association between major depression and h eadache from late childhood into early adulthood. An epidemiologically selected sample of 776 youth, aged 9-18, was assessed psychiatrically in 1983 using DISC interviews with both youth and parent informants. Reassessments were conducted in 1985-1986 and 1992. Current and past h istories of functionally impairing migraine or chronic headache were e licited in both 1985-1986 and 1992. Regression analyses examined the r elationships between major depression and headache status. The prevale nce of current functionally impairing headache was approximately 10% i n both 1985-1986 and 1992. There were lifetime and cross-sectional ass ociations between headache and major depression. Headache was approxim ately twice as common in depressed adolescents compared with nondepres sed adolescents. Major depression in adolescents, without current or p ast headache, prospectively predicted the new onset of headaches in yo ung adulthood. Among adolescents who had no history of chronic impairi ng headache in 1985-1986, those with current major depression faced a nearly tenfold increased risk of developing such headaches at some tim e during the next 7 years. Consistent with findings of retrospective s tudies among adults, a longitudinal/developmental relationship between major depression and functionally impairing headache was found in thi s prospective epidemiologic study of youth. These findings suggest tha t (1) neurochemical and pharmacologic commonalities between depression and headache should receive further investigation and that (2) it may be clinically useful to inquire about family history of headache synd romes in adolescents with major depression because such questioning ma y provide insight about the risk of subsequent functionally impairing headache in a depressed adolescent.