Headache as an Indicator of PTSD Severity
PTSD is associated with a high incidence of chronic pain.
Results of a study presented at the 2017 American Academy of Neurology Annual Meeting in Boston, April 22-28, indicate that headaches are among complaints of pain reported by patients with posttraumatic stress disorder (PTSD), and that their presence may be correlated with disorder severity.1
In addition to psychological consequences of PTSD, the disorder is associated with a high incidence of chronic pain.2 In the current study, researchers sought to investigate the prevalence of headaches in the PTSD population. A total of 101 patients with PTSD were recruited between January 2013 and December 2015 to an observational prospective study conducted to assess the incidence and type of headaches in this population. Assessment tools used in the study included a combination of the Headache Impact Test (HIT-6) and the Profile of Mood States (POMS) questionnaire.
Out of the 101 study participants, 37 patients (36.6%) reported suffering from headaches following PTSD onset, and 18 had headaches both prior to and after PTSD onset. The overall incidence of headaches in PTSD patients thus amounted to 54.5%, regardless of onset of headache. The measured HIT-6 score was 58.8 ± 8.3, with a major impact estimated for 56.4% of patients. In addition, PTSD severity and headache intensity were significantly correlated (ρ=0.35; P =.009). A majority of headaches with post-PTSD onset were reported as tension-type headaches (45.5%). Neither psychotropic drug use nor mild traumatic brain injury were found to be aggravating factors for headache. Patients with headache had higher POMS scores (P =.039), which were particularly associated with anger (P =.01) and depression (P =.047) scores.
The researchers conclude that “Headaches can be recognized in painful complaints described in PTSD especially as they may appear as a potential indicator of the severity of PTSD” and stress the need for an interdisciplinary approach to the management of PTSD.
- Guilloton L, Defrance J, Blanc PA, Trousselard M, Simson JP. Incidence and impact of headaches in the post-traumatic stress disorder. Presented at: 2017 American Academy of Neurology Annual Meeting. April 22-28, 2017; Boston, MA.
- Starr AJ, Smith WR, Frawley WH, et al. Symptoms of posttraumatic stress disorder after orthopaedic trauma. J Bone Joint Surg Am. 2004;86-A(6):1115-1121.