Baskin Steven M, Lipchik Gay L, Smitherman Todd A
New England Institute for Behavioral Medicine, Stamford, CT 06902, USA.
Headache. 2006 Oct;46 Suppl 3:S76-87. doi: 10.1111/j.1526-4610.2006.00559.x.
Although most individuals with recurrent headache disorders in the general population do not experience severe psychopathology, population-based studies and clinical investigations find high rates of comorbidity between headache and mood and anxiety disorders. When present, psychiatric disorders may complicate headache treatment and portend a poorer treatment response. The negative prognosis associated with psychiatric comorbidity emphasizes the importance of the identification of psychopathology among those with headache beginning at an early age, and suggests that the treatment of psychiatric comorbidity is warranted to improve the outcome of headache management. In this article we describe the mood and anxiety disorders most commonly associated with migraine, tension-type headache, and chronic daily headache. We provide recommendations for the assessment of comorbid mood and anxiety disorders as well as a brief overview of treatment options. Last, we discuss the clinical implications of mood and anxiety disorders on the treatment and outcome of headache.
虽然普通人群中大多数复发性头痛障碍患者没有严重的精神病理学表现，但基于人群的研究和临床调查发现，头痛与情绪及焦虑障碍之间的共病率很高。当存在精神障碍时，可能会使头痛治疗复杂化，并预示治疗反应较差。与精神共病相关的不良预后强调了从早年开始在头痛患者中识别精神病理学的重要性，并表明对精神共病进行治疗对于改善头痛管理结果是必要的。在本文中，我们描述了最常与偏头痛、紧张型头痛和慢性每日头痛相关的情绪及焦虑障碍。我们提供了评估共病情绪及焦虑障碍的建议以及治疗选择的简要概述。最后，我们讨论了情绪及焦虑障碍对头痛治疗和结果的临床影响。
