Citation

Louter MA, Wilbrink LA, Haan J, van Zwet EW, van Oosterhout WP, Zitman FG, Ferrari MD, Terwindt GM. Neurology 2016; 87(18): 1899-1906.

Affiliation

From the Departments of Neurology (M.A.L., L.A.W., J.H., W.P.J.v.O., M.D.F., G.M.T.), Psychiatry (M.A.L., F.G.Z.), and Biostatistics (E.W.v.Z.), Leiden University Medical Centre; Department of Neurosurgery (L.A.W.), Maastricht University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands. g.m.terwindt@lumc.nl.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1212/WNL.0000000000003282

PMID

27694264

Abstract

OBJECTIVE: As cluster headache (CH) is often referred to as "suicide headache," we wanted to assess the prevalence of depression in CH patients, and to investigate determinants of depression such as sleep disturbances.

METHODS: In a cross-sectional, web-based, validated questionnaire study among 462 well-defined CH patients and 177 controls, we diagnosed CH according to the ICHD-III. We assessed depression using the Hospital Anxiety and Depression Scale (HADS-D) and the Center for Epidemiologic Studies Depression scale (CES-D) with supplementary questions to assess lifetime depression. Data were analyzed with logistic and linear regression models.

RESULTS: Lifetime depression showed almost 3 times higher odds in CH patients (n = 462) than controls (n = 177) (odds ratio 2.77; 95% confidence interval 1.70-4.51). Chronic (n = 67) vs episodic (n = 394) patients had a higher prevalence of lifetime depression and more sleeping problems. Current depression was associated with having active attacks (last attack <1 month) (adjusted p = 0.02), but no effect remained after correction for sleep disturbances.

CONCLUSIONS: CH is associated with an almost 3 times increased odds of lifetime depression. Current depression is highly prevalent in patients with active disease, in part related to sleep disturbances due to current nocturnal attacks.

© 2016 American Academy of Neurology.

Language: en