The associations between pre-existing mental disorders and subsequent onset of chronic headaches: A worldwide epidemiological perspective

Although there is a significant association between pre-existing depression and later onset of chronic headache, the extent to which other pre-existing 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 (CIDI-3.0), 16 DSM-IV mental disorders 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 pre-existing mood (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 pre-existing mental disorders and subsequent headache onset (OR ranging between 1.9 for 1 up to 3.4 for 5+ pre-existing mental disorders). Our findings suggest a consistent and pervasive relationship between a wide range of pre-existing 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.status: publishe

The associations between preexisting mental disorders and subsequent onset of chronic headaches: A worldwide epidemiologic perspective

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. Perspective 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

Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys

<p>Objective: Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor has the potentially confounding role of childhood adversities been explored. The objective of this study was to examine associations between a wide range of temporally prior DSM-IV mental disorders and subsequent onset of ulcer, without and with adjustment for mental disorder comorbidity and childhood adversities.</p><p>Methods: Face-to-face household surveys conducted in 19 countries (n = 52,095; person years = 2,096,486). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Peptic ulcer onset was assessed in the same interview by self-report of physician's diagnosis and year of diagnosis. Survival analyses estimated associations between first onset of mental disorders and subsequent ulcer onset.</p><p>Results: After comorbidity and sociodemographic adjustment, depression, social phobia, specific phobia, post-traumatic stress disorder, intermittent explosive disorder, alcohol and drug abuse disorders were significantly associated with ulcer onset (ORs 1.3-1.6). Increasing number of lifetime mental disorders was associated with ulcer onset in a dose-response fashion. These associations were only slightly attenuated by adjustment for childhood adversities.</p><p>Conclusions: A wide range of mental disorders were linked with the self-report of subsequent peptic ulcer onset These associations require confirmation in prospective designs, but are suggestive of a role for mental disorders in contributing to ulcer vulnerability, possibly through abnormalities in the physiological stress response associated with mental disorders. (C) 2013 Elsevier Inc. All rights reserved.</p>