HEADACHE AND PSYCHIATRIC COMORBIDITY - CLINICAL ASPECTS AND OUTCOME IN AN 8-YEAR FOLLOW-UP-STUDY

Migraine with juvenile onset changes over time. The existence of progn ostic factors is a point of focus. A strict relationship between migra ine or tension-type headache (TTH) and psychiatric factors has been su ggested, but the exact role and the influence on evolution of headache is unknown. Objective. To analyze the evolution of migraine and TTH a nd psychiatric comorbidity (P-Co) from 1988 to 1996. Material and meth od. 100 subjects (40M, 60F; mean age 17.9 years; SD 2.7 years; range 1 2-26 years) were examined at our Center. The International Headache So ciety (MS) criteria were employed. Psychometric tests and clinical int erviews aided psychiatric diagnosis (DSM-VI-R). SCID (Structured Clini cal Interview for DSM-III-R) was employed in 1996. Chi square and logi stic regression are used for statistical analysis. Findings. Migraine and TTH change their clinical characteristics, with a high tendency to remission (mostly in males). The presence of P-Co in 1988 is related to a worsening or unchanging situation in 1996. Headache-free subjects did not present any psychiatric disorders in 1996. Anxiety disorders in 1988 are related to enduring of headache. Migraine shows comorbidit y with anxiety disorders and depression. Conclusion. P-Co is a notable problem in clinical practice. Diagnostic, prognostic, and treatment i mplications require a systematic assessment of P-Co.