Chronic headaches increase depression risk

Chronic headaches in conjunction with severe physical symptoms of a psychological origin increase the risk of major depressive disorder in women. Previous studies have shown that headache patients are predisposed to depression. Researchers from the University of Toledo-Health Science Campus in Ohio conducted a study, which included somatic symptoms, which was only previously investigated in a small study. Somatic symptoms were assessed using a questionnaire on 15 symptoms, such as stomach pain, limb pain, sleeping problems, nausea and palpitations. Low levels of education and income were associated with both chronic headache and severe disabling headache. Very disabling, chronic headaches increase the odds of depression by nearly 3.6-fold, and by 4.1-fold with migraines. If severe somatic symptoms are also present, then the odds ratios climb to 25 and 32 for all headaches and for migraines, respectively. These findings are from a study of more than 1,000 women who were seen at outpatient headache centers between June 2003 and December 2004. The subjects included 593 with episodic headaches and 439 with chronic headaches. Ninety-six percent of patients with episodic headaches and 87% with chronic headaches had migraines. The results suggest that chronic headache, disabling headache, and severe somatic symptoms work synergistically to increase the risk of depression. Alone, the presence of chronic headache had little effect on the risk of depression as compared with the effect of the combination of mild episodic headaches and minimal somatic symptoms. When the headaches become more disabling and the somatic symptoms more severe, however, the risk of depression increased markedly. People with chronic headaches tend to have a lot of somatic complaints, such as irritable bowel, pelvic pain and fibromyalgia. The study results indicate that the coexistence of these conditions dramatically increases the risk of depression. Childhood abuse and sexual abuse is much more common in women with headaches and depression than in those with headache alone.