Uysal Funda TAN, Erberk Nurperi ÖZEN, Şaziye KAZEZOĞLU, Fatma KÖKOĞLU, Cumhur BORATAY

Depression and anxiety in patients with migrane and tension-type headache

Amaç: Başağrısı olan olgularda psikiyatrik komorbidite riskinin belirlenmesi olguların yaşam kalitesi ve prognostik açıdan büyük önem taşımaktadır. Bu çalışmada migren ve gerilim tipi başağnsı (GTBA) olan hastalarda psikiyatrik bozukluklar araştırılmıştır. Hastalar ve Yöntem: Kırıkkale Üniversitesi Tıp Fakültesi Nöroloji Ana-bilim dalında ayrıntılı anamnez ve nörolojik muayene sonunda uluslararası başağnsı kriterlerine göre migren ve gerilim tipi başağnsı tanısı alan 75 kadın, 20 erkek toplam 95 hasta çalışmaya alındı. Tüm hastalara DSM-IV'de depresyon ve anksiyete bozuklukları tanı kriterleri temel alınarak hazırlanmış kırk bir soruluk bir semptom sorgulama formu verildi. Bununla birlikte hastalara Beck depresyon ölçeği (BDÖ)ve durumluluk ve sürekli anksiyete ölçeği(STAI-t ve STAI-s) (Stait and trait) uygulandı. Formların tamamlanmasını takiben olgulara psikiyatrik değerlendirme yapıldı. Bulgular: Çalışma grubunu oluşturan olguların 51 'inde (%53.7) migren ve 44'ünde (%46.3) GTBA mevcut olup ortalama yaşlan sırasıyla 32.77D7.8 ve 30.32D9.4 yıl bulundu (p=0.11.). Her iki grupta semptomların şiddeti genel olarak benzer olmasına karşın migrcnli olgularda libido azalması (p=0.02), yavaşlık (p=0.04) ve bulantı'nın (p=0.003) daha ağır olduğu görüldü. Gruplar arasında fark olmamakla beraber hem migren hem GTBA'lı olgularda BDÖ, STAI-t ve STAI-s skorlarının patolojik derecede yüksek olduğu belirlendi. Psikiyatrik değerlendirme sonrasında migrenli olguların %37.3'ünde depresyon, %15.7'sinde anksiyete, %9.8'inde depresyon+anksiyete birlikte saptanırken GTBA olguların %43.2'sinde depresyon, %9.1'inde ankziyete, %6.8'inde depresyon+anksiyete birlikte bulunuyordu (p=0.92) Sonuç: Bu çalışmada hem migren hem GTBA'sinda yüksek oranda ve benzer şiddetle depresyon ve anksiyete komorbiditesi olduğu sonucuna varılmıştır.

Migren ve gerilim tipi başağrısında depresyon ve anksiyete

Purpose: The identification of headache patients who are at risk for psychiatric comorbidity is an important quality of life and prognostic issue. The purpose of this study was to assess psychiatric comorbidity in TTH and migraine patients. Materials and Methods: The study group included 95 (75 female, 20 male) patients diagnosed with either migraine or TTH. All patients were requested to fill out a 44-item symptom list constructed according to DSM-1.V diagnostic criteria for depression and anxiety disorders and to complete the Beck Depression Inventory (BDI) and Spielberger State-trait Anxiety Inventory (STA1). After that all patients were evaluated for the presence of psychiatric disorders according to DSM-IV criteria. Results: Fifty-one (53.7%) patients had migraine while 44 (46.3%) had TTH and their mean ages were 32.77+7.8 and 30.32±9.4 years, respectively (p=0.11). The overall intensity levels of symptoms related to depression and anxiety were similar in both migraine and TTH patients. However, reduced libido (p=0.02), slowness (p=0.04) and nausea (p=0.003) were more intense in migraine patients. The mean BDI, SAI and TAI scores were elevated to the pathologic range in both migraine and TTH patients despite the absence of a significant difference between the groups. The incidences of depression, anxiety and depression+anxiety were 37.3%, 15.7% and 9.8%, respectively, in migraine patients and 43.2%, 9.1% and 6.8%, respectively, in TTH patients (p=0.92). Conclusion: Depression and anxiety disorders are common and generally similar in extent and distribution in migraine and TTH patients.

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