The Relationship of Psychiatric Comorbidities and Their Impact on Trigger Site Deactivation Surgery for Headaches.
Adult
Anxiety Disorders
/ diagnosis
Comorbidity
Depressive Disorder, Major
/ diagnosis
Female
Follow-Up Studies
Headache Disorders
/ diagnosis
Humans
Male
Middle Aged
Neurosurgical Procedures
/ statistics & numerical data
Patient Health Questionnaire
Prevalence
Prospective Studies
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Trigger Points
/ surgery
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 Nov 2021
01 Nov 2021
Historique:
entrez:
27
10
2021
pubmed:
28
10
2021
medline:
20
1
2022
Statut:
ppublish
Résumé
Patients seeking trigger site deactivation surgery for headaches often have debilitating symptoms that can affect their functional and mental health. Although prior studies have shown a strong correlation between psychiatric variables and chronic headaches, their associations in patients undergoing surgery have not been fully elucidated. This study aims to analyze psychiatric comorbidities and their impact on patients undergoing trigger site deactivation surgery for headaches. One hundred forty-two patients were prospectively enrolled. Patients were asked to complete the Patient Health Questionnaire-2 and Migraine Headache Index surveys preoperatively and at 12 months postoperatively. Data on psychiatric comorbidities were collected by means of both survey and retrospective chart review. Preoperatively, 38 percent of patients self-reported a diagnosis of depression, and 45 percent of patients met Patient Health Questionnaire-2 criteria for likely major depressive disorder (Patient Health Questionnaire-2 score of ≥3). Twenty-seven percent of patients reported a diagnosis of generalized anxiety disorder. Patients with depression and anxiety reported more severe headache symptoms at baseline. At 1 year postoperatively, patients with these conditions had successful surgical outcomes comparable to those of patients without these conditions. Patients also reported a significant decrease in their Patient Health Questionnaire-2 score, with 22 percent of patients meeting criteria suggestive of depression, compared to 45 percent preoperatively. There is a high prevalence of depression and anxiety in patients undergoing trigger site deactivation surgery. Patients with these comorbid conditions achieve successful surgical outcomes comparable to those of the general surgical headache population. Furthermore, trigger site deactivation surgery is associated with a significant decrease in depressive symptoms.
Sections du résumé
BACKGROUND
BACKGROUND
Patients seeking trigger site deactivation surgery for headaches often have debilitating symptoms that can affect their functional and mental health. Although prior studies have shown a strong correlation between psychiatric variables and chronic headaches, their associations in patients undergoing surgery have not been fully elucidated. This study aims to analyze psychiatric comorbidities and their impact on patients undergoing trigger site deactivation surgery for headaches.
METHODS
METHODS
One hundred forty-two patients were prospectively enrolled. Patients were asked to complete the Patient Health Questionnaire-2 and Migraine Headache Index surveys preoperatively and at 12 months postoperatively. Data on psychiatric comorbidities were collected by means of both survey and retrospective chart review.
RESULTS
RESULTS
Preoperatively, 38 percent of patients self-reported a diagnosis of depression, and 45 percent of patients met Patient Health Questionnaire-2 criteria for likely major depressive disorder (Patient Health Questionnaire-2 score of ≥3). Twenty-seven percent of patients reported a diagnosis of generalized anxiety disorder. Patients with depression and anxiety reported more severe headache symptoms at baseline. At 1 year postoperatively, patients with these conditions had successful surgical outcomes comparable to those of patients without these conditions. Patients also reported a significant decrease in their Patient Health Questionnaire-2 score, with 22 percent of patients meeting criteria suggestive of depression, compared to 45 percent preoperatively.
CONCLUSIONS
CONCLUSIONS
There is a high prevalence of depression and anxiety in patients undergoing trigger site deactivation surgery. Patients with these comorbid conditions achieve successful surgical outcomes comparable to those of the general surgical headache population. Furthermore, trigger site deactivation surgery is associated with a significant decrease in depressive symptoms.
Identifiants
pubmed: 34705787
doi: 10.1097/PRS.0000000000008428
pii: 00006534-202111000-00031
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1113-1119Informations de copyright
Copyright © 2021 by the American Society of Plastic Surgeons.
Déclaration de conflit d'intérêts
Disclosure:The authors have no conflict of interests to disclose.
Références
Guyuron B, Reed D, Kriegler JS, Davis J, Pashmini N, Amini S. A placebo-controlled surgical trial of the treatment of migraine headaches. Plast Reconstr Surg. 2009;124:461–468.
Janis JE, Barker JC, Javadi C, et al. A review of current evidence in the surgical treatment of migraine headaches. Plast Reconstr Surg. 2014;134(Suppl 2):131S–141S.
Gfrerer L, Maman DY, Tessler O, Austen WG Jr. Nonendoscopic deactivation of nerve triggers in migraine headache patients: Surgical technique and outcomes. Plast Reconstr Surg. 2014;134:771–778.
Guyuron B, Varghai A, Michelow BJ, et al. Corrugator supercilii muscle resection and migraine headaches. Plast Reconstr Surg. 2000;106:429–434discussion 435–437.
Guyuron B, Tucker T, Davis J. Surgical treatment of migraine headaches. Plast Reconstr Surg. 2002;109:2183–2189.
Dirnberger F, Becker K. Surgical treatment of migraine headaches by corrugator muscle resection. Plast Reconstr Surg. 2004;114:652–657discussion 658–659.
Caviggioli F, Giannasi S, Vinci V, Cornegliani G, Levi D, Gaetani P. Five-year outcome of surgical treatment of migraine headaches. Plast Reconstr Surg. 2011;128:564e–565e.
Radat F, Swendsen J. Psychiatric comorbidity in migraine: A review. Cephalalgia2005;25:165–178.
McLean G, Mercer SW. Chronic migraine, comorbidity, and socioeconomic deprivation: Cross-sectional analysis of a large nationally representative primary care database. J Comorb. 2017;7:89–95.
Trejo-Gabriel-Galan JM, Aicua-Rapún I, Cubo-Delgado E, Velasco-Bernal C. Suicide in primary headaches in 48 countries: A physician-survey based study. Cephalalgia2018;38:798–803.
Heckman BD, Holroyd KA, Himawan L, et al. Do psychiatric comorbidities influence headache treatment outcomes? Results of a naturalistic longitudinal treatment study. Pain2009;146:56–64.
Bhatia MS, Gupta R. Migraine: Clinical pattern and psychiatric comorbidity. Ind Psychiatry J. 2012;21:18–21.
Green MW. Headaches: Psychiatric aspects. Neurol Clin. 2011;29:65–80, vii.
Guidetti V, Galli F. Psychiatric comorbidity in chronic daily headache: Pathophysiology, etiology, and diagnosis. Curr Pain Headache Rep. 2002;6:492–497.
Smitherman TA, Rains JC, Penzien DB. Psychiatric comorbidities and migraine chronification. Curr Pain Headache Rep. 2009;13:326–331.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381.
Janis JE, Dhanik A, Howard JH. Validation of the peripheral trigger point theory of migraine headaches: Single-surgeon experience using botulinum toxin and surgical decompression. Plast Reconstr Surg. 2011;128:123–131.
Nicholas MK. The pain self-efficacy questionnaire: Taking pain into account. Eur J Pain2007;11:153–163.
Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a two-item depression screener. Med Care2003;41:1284–1292.
Adenuga P, Brown M, Reed D, Guyuron B. Impact of preoperative narcotic use on outcomes in migraine surgery. Plast Reconstr Surg. 2014;134:113–119.
Ortiz R, Gfrerer L, Hansdorfer MA, Tsui JM, Nealon KP, Austen WG Jr. The efficacy of surgical treatment for headaches in patients with prior head or neck trauma. Plast Reconstr Surg. 2020;146:381–388.
Breslau N, Lipton RB, Stewart WF, et al. Comorbidity of migraine and depression: Investigating potential etiology and prognosis. Neurology2003;60:1308–1312.
Hamelsky SW, Lipton RB. Psychiatric comorbidity of migraine. Headache2006;46:1327–1333.
Lake AE III, Rains JC, Penzien DB, Lipchik GL. Headache and psychiatric comorbidity: Historical context, clinical implications, and research relevance. Headache2005;45:493–506.
Breslau N, Schultz L, Lipton R, Peterson E, Welch KM. Migraine headaches and suicide attempt. Headache2012;52:723–731.
Yang Y, Ligthart L, Terwindt GM, Boomsma DI, Rodriguez-Acevedo AJ, Nyholt DR. Genetic epidemiology of migraine and depression. Cephalalgia2016;36:679–691.
Hamel E. Serotonin and migraine: Biology and clinical implications. Cephalalgia2007;27:1293–1300.
Drummond PD. Tryptophan depletion increases nausea, headache and photophobia in migraine sufferers. Cephalalgia2006;26:1225–1233.
Marino E, Fanny B, Lorenzi C, et al. Genetic bases of comorbidity between mood disorders and migraine: Possible role of serotonin transporter gene. Neurol Sci. 2010;31:387–391.
Dresler T, Caratozzolo S, Guldolf K, et al.; European Headache Federation School of Advanced Studies (EHF-SAS). Understanding the nature of psychiatric comorbidity in migraine: A systematic review focused on interactions and treatment implications. J Headache Pain2019;20:51.
Boudreau GP, Grosberg BM, McAllister PJ, Lipton RB, Buse DC. Prophylactic onabotulinumtoxinA in patients with chronic migraine and comorbid depression: An open-label, multicenter, pilot study of efficacy, safety and effect on headache-related disability, depression, and anxiety. Int J Gen Med. 2015;8:79–86.
Zhang H, Zhang H, Wei Y, Lian Y, Chen Y, Zheng Y. Treatment of chronic daily headache with comorbid anxiety and depression using botulinum toxin A: A prospective pilot study. Int J Neurosci. 2017;127:285–290.
Martin PR, Aiello R, Gilson K, Meadows G, Milgrom J, Reece J. Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial. Behav Res Ther. 2015;73:8–18.
Arroll B, Goodyear-Smith F, Crengle S, et al. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med. 2010;8:348–353.