Prevalence of Depression Symptoms in Outpatients with a Complaint of Headache

PURPOSE: This case-control study was designed to determine whether adults who present to a primary care office with a chief complaint of headache have more reported symptoms of depression than adults presenting with other problems. METHODS: Adult, English-speaking patients who presented to a primary care office with a chief complaint of headache were matched to adult patients of the same age and sex who presented with problems other than headache. All participants completed the PRIME-MD 9-item Patient Health Questionnaire as a screen for depression. RESULTS: A total of 200 participants entered the study. The mean age of the participants was 43.8 years (range, 18-87 years). Women constituted 84% of the participants. Of those patients who presented with headache, 32% had a likelihood of possible major depressive disorder compared with 12% in the patients presenting without headache. CONCLUSIONS: Almost one-third of adult patients who present to a primary care office with a complaint of headache report moderate symptoms of depression when screened compared with approximately 10% of patients presenting with a complaint other than headache. Given such a high prevalence of these symptoms, primary care physicians should screen all adult patients who present with headache for depression.