Major depression occurs very frequently among patients with chronic headaches, researchers report.

“However, primary care physicians often fail to recognize the coexistence of major depressive episode,” Dr. Tetsuhiro Maeno, of the University of Tsukuba, Japan, and colleagues write in the medical journal Headache.

The team studied 177 consecutive adult primary-care patients whose main illness was headache, and who were seen over a 1-year period.

The subjects completed a questionnaire that asked about the duration and severity of headaches, changes in headache severity, and other symptoms. A short standardized interview was used to diagnose major depression.

Forty-five of the patients (25%) were found to have a major depressive episode.

The investigators saw that depression was more likely in patients who had severe headache, longer headache duration, and multiple symptoms.

“When primary care physicians notice patients with headaches lasting more than 6 months or with headaches accompanied by multiple (physical) symptoms, it is recommended that they ascertain whether major depressive episode coexists,” Maeno and colleagues suggest.

SOURCE: Headache, October 2007.