Psychiatric perspectives on headache and facial pain.
For a subset of headache patients, an understanding of psychological antecedents and interpersonal difficulties is an important part of the headache evaluation. This subset includes patients with chronic headache, frequent headache, treatment-refractory headache, analgesic misuse problems, and serious compliance issues. Inadequate coping with stress is central to the persistence of headache in many such patients. Other patients present to the headache specialist but actually suffer from a serious comorbid psychiatric disorder, such as major depression, panic disorder, substance abuse, or personality disorder. For successful treatment of headache, it is important that these related problems be detected and either treated (as outlined here) or referred to a specialist for treatment.
Jacobson
Sandra A
SA
Tufts University School of Medicine, New England Medical Center, Box 1007, 750 Washington Street, Boston, MA 02111, USA. saj@comcast.net
Folstein
Marshal F
MF
D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005156:Facial Neuralgia / Q000453:epidemiology* / Q000523:psychology*; D006261:Headache / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology