Depression Disorders and Functional Impairment in Patients with Persistent Headaches.

Kremastinou F., Veneti V., Kouroukli I., Panaretou V., Tsirtsiridou V., Kostopoulou F., Georgiou L.. Department of Anesthesiology, Pain Clinic, “Ippokration” General Hospital of Athens.
Poster Presentation at the 5th Congress of the European Federation of the IASP Chapters (EFIC), Instabul, Turkey, September 13-16, 2006 “Europe Against Pain, Don’t Suffer in

BACKGROUND AND AIM
According to bibliography, patients who suffered from persistent pain have a high probability to develop depression disorders. Based on the above, patients who suffer from persistent headaches may develop depression and functional impairment as a consequence of their pain situation.
The aim of the present study was:
1)To determine the relationship between persistent headaches and depression disorders
2)To measure the functional impairment associated with persistent headaches of patients treated in our
Pain Clinic.
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MATERIAL AND METHODS
From October 2005 to April 2006 42 patients ( 7 men and 35 women) suffering from severe headaches were referred to our Pain Clinic.
All patients were interviewed by a certified psychologist in order to:
A) asses the relationship between persistent headache and depression disorder (defined by DSM-IV-TR as normal mood, life stress, preexisting depression disorder, major depressive disorder due to pain, personality disorders, suicidal ideation) and
B) To measure functional difficulties associated with pain.
The type of headache (persistent or non persistent - tension type headache, migraine, mixed headache and cluster headache) the duration, and the intensity of the pain (VAS 0-10) were recorded before and after treatment. Statistical analysis was done using SPSS V. 11 program (p<0.05 was considered as significant)

RESULTS
34patients(81% ) suffered persistent headache. 8 patients (19%) suffered non persistent headache.78 %of persistent headache patients are depression sufferers. 55% have functional impairment due to depression. There appears to be an association between persistent headache and depression disorder (R=0.645, p<0.0001. There is also a correlation between the depression disorder and functional impairment (R=0,649, P<0,0001).

CONCLUSIONS
Headache sufferers have a high prevalence of depressive disorder because pain changes the quality of their lives. They are very affected emotionally because of the unpredictability of the attacks and the limited ability to control the pain once it starts. Persistent headache is associated with increased functional impairment. Treatment improves the patients’ psychological situation.