ArticleThe journal of headache and pain2020
Lost productivity associated with headache and depression: a quality improvement project identifying a patient population at risk.
Article in The journal of headache and pain, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Comorbidities of primary headache disorders: a literature review with meta-analysis.The journal of headache and pain · 2021Pooled it
- Trial
- Associations Between Type D Personality, Psychological Symptoms, Pain Severity, and Migraine-Related Outcomes in Women with Migraine.Journal of clinical medicine · 2026Article
- A potential neuroimaging biomarker for depression in migraine patients: imbalance in excitation and inhibition in the medial superior frontal cortex.Journal of psychiatry & neuroscience : JPN · 2026Article
- Headache Management in Military Primary Care: Findings from a Nationwide Cross-Sectional Study.Journal of clinical medicine · 2025Article
- Evaluation of burnout levels among healthcare staff in anesthesiology departments in Greece - Is there a connection with anxiety and depression?AIMS public health · 2024Article
- Depression in healthcare workers: Results from the nationwide AMADEUS survey.International journal of nursing studies · 2022Article
- Potential Progression Mechanism and Key Genes in Early Stage of mTBI.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Burden of migraine among Japanese patients: a cross-sectional National Health and Wellness Survey.The journal of headache and pain · 2020Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis quality improvement project was implemented in order to highlight the association between headache, mTBI and depression on lost productivity and resource utilization.
backgroundMood disorders, environment and traumatic brain injury are common in patients with headache, and have been shown to influence clinical course, treatment response and outcome. Although widely recognized, the association of these factors on clinical outcomes, resource utilization and productivity is not well understood.
methodsAll patients presenting to a military referral center for migraines are assessed for presence of traumatic brain injury, Headache Impact Score (HIT-6) and Patient Depression Questionnaire (PHQ-9). Based on screening, patients are offered referral to mental health and a multidisciplinary headache education course.
results237 patients were seen for headache or migraine. 180 patients had severely disabling headaches. These patients accounted for 146 emergency room visits over the course of one year. Of headache patients, 65% met criteria for depression and 15% of patients had severe depression. Only 37% of these patients carried a formal diagnosis of depression and 38% had been seen by mental health. Lost productivity and duty limitations were significantly associated with severity of depression. In service members screening positively for mild, moderate or severe depression, duty restrictions had been placed on 8.3%, 32.5% and 53.8%, respectively. Only 3.8% of patients who did not screen for depression had similar duty limitations. A history of mTBI strongly correlated with comorbid depression. Lost productivity and duty limitations were not impacted by other headache characteristics or HIT-6 scores.
conclusionsThis quality improvement project identified a practice gap for treatment of comorbid depression in patients presenting to Neurology for headache. Depression strongly correlated with productivity loss, highlighting a possible target for the economic burden of headache.
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