This case study explores the diagnosis and treatment of a 51-year-old female with exacerbated anxiety and depressive symptoms, which worsened prior to menstruation. Initial concerns involved the maximum dosage of psyc...This case study explores the diagnosis and treatment of a 51-year-old female with exacerbated anxiety and depressive symptoms, which worsened prior to menstruation. Initial concerns involved the maximum dosage of psychiatric medications with persistent major depressive disorder and suicidal ideations. This led to a referral for a comprehensive evaluation to assess potential underlying medical conditions. The evaluation revealed multiple contributing factors, including hormonal imbalances, hypothyroidism, and vitamin deficiencies. This case highlights the importance of a thorough diagnostic approach to identify and address underlying conditions that may exacerbate mental health issues.展开更多
Background： Many studies have reported that depression and anxiety have bidirectional relationship with headache. However, few researches investigated the roles of depression or anxiety in patients with headache. We ...Background： Many studies have reported that depression and anxiety have bidirectional relationship with headache. However, few researches investigated the roles of depression or anxiety in patients with headache. We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals. Additional risk factors for depression and anxiety were also analyzed. Methods： A cross-sectional study was conducted at 11 general neurological clinics. All consecutive patients with a chief complaint of headache were enrolled. Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview, and those for headache were made according to the International Classification of Headache Disorders, 2＇ld Edition. The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity. Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety. Results： A total of 749 outpatients with headache were included. Among them, 148 （19.7%） were diagnosed with depression and 103 （13.7%） with anxiety. Further analysis showed that 114 （15.2%） patients complaining headache due to somatic symptoms of psychiatric disorders and 82 （10.9%） had a depression or anxiety comorbidity with headache. Most patients with depression or anxiety manifested mild to moderate headaches. Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety. Conclusion： Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.展开更多
文摘This case study explores the diagnosis and treatment of a 51-year-old female with exacerbated anxiety and depressive symptoms, which worsened prior to menstruation. Initial concerns involved the maximum dosage of psychiatric medications with persistent major depressive disorder and suicidal ideations. This led to a referral for a comprehensive evaluation to assess potential underlying medical conditions. The evaluation revealed multiple contributing factors, including hormonal imbalances, hypothyroidism, and vitamin deficiencies. This case highlights the importance of a thorough diagnostic approach to identify and address underlying conditions that may exacerbate mental health issues.
基金Data analysis was supported,in part,by grants from the National Natural Science Foundation of China，the Beijing Municipal New Stars Science and Technology Project
文摘Background： Many studies have reported that depression and anxiety have bidirectional relationship with headache. However, few researches investigated the roles of depression or anxiety in patients with headache. We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals. Additional risk factors for depression and anxiety were also analyzed. Methods： A cross-sectional study was conducted at 11 general neurological clinics. All consecutive patients with a chief complaint of headache were enrolled. Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview, and those for headache were made according to the International Classification of Headache Disorders, 2＇ld Edition. The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity. Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety. Results： A total of 749 outpatients with headache were included. Among them, 148 （19.7%） were diagnosed with depression and 103 （13.7%） with anxiety. Further analysis showed that 114 （15.2%） patients complaining headache due to somatic symptoms of psychiatric disorders and 82 （10.9%） had a depression or anxiety comorbidity with headache. Most patients with depression or anxiety manifested mild to moderate headaches. Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety. Conclusion： Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.
