The High Level of Psychiatric Disorders Associated with Migraine or Tension-type Headache in Adolescents

Objectives: This study aimed to evaluate the relation between psychiatric disorders, andmigraine or tensiontype headache (TTH), together with severity of depression and anxiety symptoms, in adolescents with headache. Methods: Headache types of 140 adolescents aged 12 to 18 years were investigated by a headache specialist, through facetoface interviews according to the diagnostic criteria of International Classification of Headache Disorders, 3rd edition beta version (ICHD3 beta). Psychiatric disorders of participants were assessed via DSMIV diagnostic criteria. Sociodemographic information form, Depression Scale, and the StateTrait Anxiety Scale for Children were applied to the patients accordingly. Results: Higher rates of psychiatric disorders (82%) were observed in the migraine and tensiontype headache (TTH) groups. The most frequent comorbid psychiatric disorder was anxiety disorder. In patients with TTH, the number of attacks was statistically higher. In patients with migraine, the frequency of throbbing headache was elevated with the co-occurrence of anxiety disorder and attention deficit hyperactivity disorder (ADHD). In patients with TTH, the description of worsening of pain with movement was raised with anxiety disorder comorbidity. A weak correlation existed between headache prevalence and headache severity in patients with migraine. Similarly, in the TTH group, a weak association between headache prevalence and depressionanxiety scores were reported. Conclusions: Our findings support the association between migraine or TTH and anxiety and depression symptoms in adolescents. This highlights the importance of headache considering possible comorbid psychiatric disorders. This implies a necessity for multidisciplinary and prospective clinical studies to make clear the importance of the chronification hypothesis