Beghi E, Allais G, Cortelli P, D'Amico D, De Simone R, d'Onofrio F, Genco S, Manzoni G C, Moschiano F, Tonini M C, Torelli P, Quartaroli M, Roncolato M, Salvi S, Bussone G
Istituto Laboratorio di Malattie Neurologiche Mario Negri, Via Eritrea 62, I-20157 Milan, Italy.
Neurol Sci. 2007 May;28 Suppl 2:S217-9. doi: 10.1007/s10072-007-0780-6.
Psychiatric comorbidity (prevalence and types) was tested in a naturalistic sample of adult patients with pure migraine without aura, and in two control groups of patients, one experiencing pure tension-type headache and the other combined migraine and tension-type headaches. The study population included 374 patients (158, 110 and 106) from nine Italian secondary and tertiary centres. Psychiatric comorbidity was recorded through structured interview and also screened with the Mini International Neuropsychiatry Interview (MINI). Only anxiety and depression were investigated. Psychiatric disorders were reported by 49 patients (14.6%; 10.9% of patients with migraine, 12.8% of those with tension-type headache and 21.4% of those with combined migraine and tension-type headaches). The MINI interview detected a depressive episode in 59.9% of patients with migraine, 68.3% of patients with tension-type headache and 69.6% of patients with combined migraine and tension-type headaches. Depression subtypes were significantly different across groups (p=0.03). Anxiety (mostly generalised) was reported by 18.4% of patients with migraine, 19.3% of patients with tension-type headache, and 18.4% of patients with combined migraine and tension-type headaches. The values for panic disturbance were 12.7, 5.5 and 14.2, and those for obsessive-compulsive disorders were 2.3, 1.1 and 9.4% (p=0.009). Based on these results, psychopathology of primary headache can be a reflection of the burden of the disease rather than a hallmark of a specific headache category.
在一组无先兆的单纯偏头痛成年患者的自然样本中，以及在两组对照患者中，测试了精神共病（患病率和类型），其中一组经历单纯紧张型头痛，另一组经历偏头痛与紧张型头痛合并发作。研究人群包括来自意大利九个二级和三级中心的374名患者（分别为158名、110名和106名）。通过结构化访谈记录精神共病情况，并使用迷你国际神经精神病学访谈（MINI）进行筛查。仅对焦虑和抑郁进行了调查。49名患者报告有精神障碍（14.6%；偏头痛患者中为10.9%，紧张型头痛患者中为12.8%，偏头痛与紧张型头痛合并发作患者中为21.4%）。MINI访谈在59.9%的偏头痛患者、68.3%的紧张型头痛患者和69.6%的偏头痛与紧张型头痛合并发作患者中检测到抑郁发作。抑郁亚型在各组之间存在显著差异（p = 0.03）。18.4%的偏头痛患者、19.3%的紧张型头痛患者和18.4%的偏头痛与紧张型头痛合并发作患者报告有焦虑（大多为广泛性焦虑）。惊恐障碍的比例分别为12.7%、5.5%和14.2%，强迫症的比例分别为2.3%、1.1%和9.4%（p = 0.009）。基于这些结果，原发性头痛的精神病理学可能是疾病负担的一种反映，而非特定头痛类型的标志。
