Bruffaerts R et al. The associations between preexisting mental disorders and subsequent onset of chronic headaches: a worldwide epidemiologic perspective. J Pain. 2015 Jan;16(1):42-52. Epub 2014 Oct 22. PMID: 25451620.

J Pain. 2015 Jan;16(1):42-52. doi: 10.1016/j.jpain.2014.10.002. Epub 2014 Oct 22.

The associations between preexisting mental disorders and subsequent onset of chronic headaches: a worldwide epidemiologic perspective.

Bruffaerts R(1), Demyttenaere K(2), Kessler RC(3), Tachimori H(4), Bunting B(5), Hu C(6), Florescu S(7), Haro JM(8), Lim CC(9), Kovess-Masfety V(10), Levinson D(11), Medina Mora ME(12), Piazza M(13), Piotrowski P(14), Posada-Villa J(15), Salih Khalaf M(16), ten Have M(17), Xavier M(18), Scott KM(9).

Author information:
(1)Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium. Electronic address: ronny.bruffaerts@med.kuleuven.be.
(2)Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
(3)Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
(4)National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
(5)Psychology Research Institute, University of Ulster, Londonderry, Northern Ireland.
(6)Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Guangdong Province, PR China.
(7)National School of Public Health, Management and Professional Development, Romania.
(8)Saint John of God Health Park, Barcelona, Spain.
(9)Department of Psychological Medicine, Otago University, Dunedin, New Zealand.
(10)Université Paris Descartes & EHESP School for Public Health Department of Epidemiology, Paris, France.
(11)Mental Health Services, Ministry of Health, Jerusalem, Israel.
(12)National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
(13)Mental Health, Alcohol and Drugs Research Unit, School of Public Health, Universidad Peruana Cayetano, Heredia, Peru.
(14)Wroclaw Medical University, Wroclaw, Poland.
(15)Colegio Mayor de Cundinamarca University, Bogota, DC, Colombia.
(16)Ibn Sena Teaching Hospital, Mosul, Iraq.
(17)Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
(18)Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.

Although there is a significant association between preexisting depression and later onset of chronic headache, the extent to which other preexisting mental disorders are associated with subsequent onset of headache in the general population is not known. Also unknown is the extent to which these associations vary by gender or by life course. We report global data from the WHO's World Mental Health surveys (n = 52,095), in which, by means of the Composite International Diagnostic Interview-3.0, 16 mental disorders from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were retrospectively assessed in terms of lifetime prevalence and age of onset. Frequent or severe headaches were assessed using self-reports. After adjustment for covariates, survival models showed a moderate but consistent association between preexisting mood (odds ratios [ORs] = 1.3-1.4), anxiety (ORs = 1.2-1.7), and impulse-control disorders (ORs = 1.7-1.9) and the subsequent onset of headache. We also found a dose-response relationship between the number of preexisting mental disorders and subsequent headache onset (OR ranging from 1.9 for 1 preexisting mental disorder to 3.4 for ≥5 preexisting mental disorders). Our findings suggest a consistent and pervasive relationship between a wide range of preexisting mental disorders and the subsequent onset of headaches. This highlights the importance of assessing a broad range of mental disorders, not just depression, as specific risk factors for the subsequent onset of frequent or severe headaches.

PERSPECTIVE: This study shows that there is a temporal association between a broad range of preexisting mental disorders and the subsequent onset of severe or frequent headaches in general population samples across the world.

Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

DOI: 10.1016/j.jpain.2014.10.002

PMID: 25451620 [PubMed - indexed for MEDLINE]

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