Tag: CDH

Mental Health, News & Research

Teenagers With Chronic Daily Headache or Migraine Have Greater Suicide Risk

Kerrie Smyres

Young teenagers with chronic daily headache, particularly migraine with aura, have a six times greater risk of suicide than teens without headache disorders. This is according to a study in Taipei of 7,900 teenagers between the ages of 12 and 14.

From Medscape (you can get a password from BugMeNot):

“Young adolescents with chronic daily headache (CDH), particularly those who have migraines with aura, are at 6 times greater risk for suicide than their headache-free peers, new research suggests.”

“Individuals with migraine headaches were 3.5 times more likely to have a psychiatric disorder than those without migraine. In addition, the investigators found those who had migraine with aura were at even greater risk for psychiatric disorders and higher suicide risk.”

“Age and sex effects were also associated with increased risk for depressive disorders, but not anxiety disorders. Female subjects were more likely to have major depression than male participants (26% vs 7%). They were also much more likely than their male counterparts to have any type of depressive disorder (37% vs 10%).”

It’s scary news, but as someone who had migraine and chronic daily headache and depression as a teenager, I’m not surprised. If you have a child with a headache disorder or are an adult with one, please take a look at these important notes:

Chronic daily headache is defined as 15 or more headache days per month. Even if your child doesn’t have a headache or migraine every single day, he or she could have chronic daily headache.

While being sad, frustrated or anxious are common emotions for people with chronic illness, they can also be indicators of a psychiatric disorder. Depression or anxiety are real, serious physiological disorders that
many headache sufferers also have. Psychiatric and headache disorders are often referred to as comorbid conditions.

Headaches and nausea are the most obvious symptoms of migraine, but migraines can also cause many other symptoms. These include mental confusion, trouble understanding and finding words, irritability, hyperactivity, sweating and sighing. Such little-known symptoms can be as debilitating and disturbing as the pain.

Adults with migraine also have a higher risk of suicide than people without. This graph* is shocking.

If you are feeling suicidal, please call a hotline for help. In the US call 1-800-273-TALK (8255) or 1-800-SUICIDE (784-2433). If you live anywhere else, check this list of international suicide prevention hotlines.

*The site with the graph is no longer loading. I know it’s a reputable site, so I’m keeping the link in thinking that the site will magically regenerate.

Treatment

Promising Study for Acupuncture, Meds & CDH

Kerrie Smyres

The October issue of Headache reports results of a controlled trial of acupuncture for chronic daily headache. Researchers set out to see if people with CDH may benefit from treatment other than meds because “medical management” alone is often ineffective. The results indicate that, yes, CDH patients who combine acupuncture and meds suffer less than those who just take meds.

Unfortunately, the entire article is only available to registered Medscape users, but the abstract is viewable for everyone.

Methods
In a six-week period, the 74 participants either underwent 10 acupuncture sessions and had medical management by a neurologist or they only received medical management. Three neurologists from the same headache clinic, all of whom have “extensive experience” treating headache, provide the medical management.

There was no “sham” acupuncture, so participants and researchers both knew which group each patient was in.

Measurements and Tools
Health-related quality of life was examined using the Headache Inventory Test. Participants also told researchers the frequency and severity of their headaches in the month before the study. General health was assessed with a standardized health survey. Depression was checked using the Beck Depression Inventory.

Results
Participants who only had medical management did not show improvement. Compared to these patients, those who received medical management and acupuncture had and improvement of 3.0 points on the Headache Impact Test, as well as an increase of 8 or more points on the general health survey. Participants who received acupuncture were 3.7 times more likely to report less suffering from headaches at the end of the study.

Article authors do stress that participants with acupuncture report less suffering. They may actually have less pain, but they may also just perceive that they have less pain. Perception is reality. I doubt headache sufferers care if they actually have less pain or just think that they do. Either way they feel better.

Patient Education

Different Causes of CDH

Kerrie Smyres

I tend to use chronic daily headache and migraine interchangeably because my chronic migraines are thought to have transformed into daily headaches. I’m trying to stop doing this, though, because migraine is not the only instigator of CDH. In fact, the International Headache Society has identified 24 different causes for it.

American Family Physician published an article in December 2004 that describes the causes of chronic daily headache in the US and Europe. In 53% of cases, CDH begins from chronic tension-type headaches. Another 31% are chronic migraines that have transformed into daily headaches. In both type, the headaches gradually change from being distinct events to constant. Another common cause with a gradual onset is medication overuse, a.k.a. rebound headaches.

For the majority of those with CDH, one or more of the above classifications will fit. But for others, CDH may be brought on suddenly by head or neck trauma, flu-like illness, surgery, meningitis, or some other medical illness. I don’t know much about this second set of causes and I don’t really know how they are treated. But I expect that we experience very similar things with the different types of CDH.