Study of psychiatric comorbidity in patients with headache using a short structured clinical interview in a rural neurology clinic in Western India

BACKGROUND: Psychiatric disorders are common in patients attending neurology clinics with headache. Evaluation of psychiatric comorbidity in patients with headache is often missed in the busy neurology clinics. AIMS: To assess the prevalence of Axis-I DSM-IV psychiatric disorders in patients with primary headache disorders in a rural-based tertiary neurology clinic in Western India. SETTINGS AND DESIGN: : A cross-sectional observation survey was conducting assessing all patients with migraine, tension-type headache and chronic daily headache attending the Neurology Clinic of Shree Krishna Hospital, a rural medical teaching hospital in Karamsad, in Gujarat in Western India. MATERIALS AND METHODS: A total of 101 consecutive consenting adults with headache were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I.), a structured diagnostic clinical interview to assess prevalence of Axis-I DSM-IV psychiatric disorders. STATISTICAL ANALYSIS: Descriptive statistics were calculated using SPSS software version 16 and a binomial regression model was used to study the relationship of psychiatric co-morbidity with patient-related factors. RESULTS: 49 out of 101 (48.5%) patients with headache suffered from depressive disorders (dysthymia or depression or suicidality), 18 out of 101 patients with headache (17.90%) suffered from anxiety related disorders (generalized anxiety disorder or agoraphobia or social phobia or panic disorder). CONCLUSIONS: Axis-I psychiatric disorders are a significant comorbidity among patients with headache disorders. M.I.N.I. can be used as a short, less time consuming instrument to assess all patients with headache disorders.