• Byung-Su Kim, Pil-Wook Chung, Byung-Kun Kim, Mi Ji Lee, Jeong Wook Park, Min Kyung Chu, Jin-Young Ahn, Dae Woong Bae, Tae-Jin Song, Jong-Hee Sohn, Kyungmi Oh, Daeyoung Kim, Jae-Moon Kim, Soo-Kyoung Kim, Yun-Ju Choi, Jae Myun Chung, Heui-Soo Moon, Chin-Sang Chung, Kwang-Yeol Park, and Soo-Jin Cho.
• Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, South Korea.
• J Headache Pain. 2020 May 29; 21 (1): 58.

BackgroundOur aim was to investigate the relationship between coexisting cluster headache (CH) and migraine with anxiety and depression during active cluster bouts, and how symptoms change during remission.MethodsWe analyzed data from 222 consecutive CH patients and 99 age- and sex-matched controls using a prospective multicenter registry. Anxiety or depression was evaluated using the Generalized Anxiety Disorder-7 (GAD-7) or Patient Health Questionnaire-9 (PHQ-9), respectively. Moderate-to-severe anxiety or depression was defined as a score of ≥10 at baseline (during a cluster bout). We assessed for changes in anxiety and depression during CH remission periods.ResultsAmong the CH patients, the prevalence of moderate-to-severe anxiety and depression was seen in 38.2% and 34.6%, respectively. Compared with controls, CH patients were associated with moderate-to-severe anxiety and depression (multivariable-adjusted odds ratio [aOR] = 7.32, 95% confidence intervals [CI] = 3.35-15.99 and aOR = 4.95, 95% CI = 2.32-10.57, respectively). CH patients with migraine were significantly more likely to have moderate-to-severe anxiety and depression (aOR = 32.53, 95% CI = 6.63-159.64 and aOR = 16.88, 95% CI = 4.16-68.38, respectively), compared to controls without migraine. The GAD-7 and PHQ-9 scores were significantly reduced between cluster bout and remission periods (from 6.8 ± 5.6 to 1.6 ± 2.8; P < 0.001, and from 6.1 ± 5.0 to 1.8 ± 2.4; P < 0.001, respectively).ConclusionsOur results indicate that CH patients are at increased risk of anxiety and depression, especially in the presence of coexisting migraine. However, the anxiety and depression can improve during remission periods.

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