Bruffaerts Ronny, Demyttenaere Koen, Kessler Ronald C, Tachimori Hisateru, Bunting Brendan, Hu Chiyi, Florescu Silvia, Haro Josep Maria, Lim Carmen C W, Kovess-Masfety Viviane, Levinson Daphna, Medina Mora Maria Elena, Piazza Marina, Piotrowski Patryk, Posada-Villa Jose, Salih Khalaf Mohammad, ten Have Margreet, Xavier Miguel, Scott Kate M
Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
J Pain. 2015 Jan;16(1):42-52. doi: 10.1016/j.jpain.2014.10.002. Epub 2014 Oct 22.
Although there is a significant association between preexisting depression and later onset of chronic headache, the extent to which other preexisting mental disorders are associated with subsequent onset of headache in the general population is not known. Also unknown is the extent to which these associations vary by gender or by life course. We report global data from the WHO's World Mental Health surveys (n = 52,095), in which, by means of the Composite International Diagnostic Interview-3.0, 16 mental disorders from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, were retrospectively assessed in terms of lifetime prevalence and age of onset. Frequent or severe headaches were assessed using self-reports. After adjustment for covariates, survival models showed a moderate but consistent association between preexisting mood (odds ratios [ORs] = 1.3-1.4), anxiety (ORs = 1.2-1.7), and impulse-control disorders (ORs = 1.7-1.9) and the subsequent onset of headache. We also found a dose-response relationship between the number of preexisting mental disorders and subsequent headache onset (OR ranging from 1.9 for 1 preexisting mental disorder to 3.4 for ≥5 preexisting mental disorders). Our findings suggest a consistent and pervasive relationship between a wide range of preexisting mental disorders and the subsequent onset of headaches. This highlights the importance of assessing a broad range of mental disorders, not just depression, as specific risk factors for the subsequent onset of frequent or severe headaches.
This study shows that there is a temporal association between a broad range of preexisting mental disorders and the subsequent onset of severe or frequent headaches in general population samples across the world.
虽然既往抑郁症与慢性头痛的后期发作之间存在显著关联，但在普通人群中，其他既往精神障碍与后续头痛发作的关联程度尚不清楚。这些关联在性别或生命历程方面的差异程度也不明确。我们报告了世界卫生组织世界心理健康调查的全球数据（n = 52,095），通过复合国际诊断访谈-3.0，对《精神障碍诊断与统计手册》第四版中的16种精神障碍的终生患病率和发病年龄进行了回顾性评估。使用自我报告评估频繁或严重头痛情况。在对协变量进行调整后，生存模型显示，既往情绪障碍（优势比[ORs]=1.3 - 1.4）、焦虑症（ORs = 1.2 - 1.7）和冲动控制障碍（ORs = 1.7 - 1.9）与后续头痛发作之间存在中度但一致的关联。我们还发现，既往精神障碍的数量与后续头痛发作之间存在剂量反应关系（OR范围从1种既往精神障碍的1.9到≥5种既往精神障碍的3.4）。我们的研究结果表明，广泛的既往精神障碍与后续头痛发作之间存在一致且普遍的关系。这凸显了评估广泛的精神障碍而非仅抑郁症作为频繁或严重头痛后续发作的特定危险因素的重要性。
这项研究表明，在世界各地的普通人群样本中，广泛的既往精神障碍与后续严重或频繁头痛发作之间存在时间上的关联。
