Conflict of Interest: None.
Post-Traumatic Stress Disorder in U.S. Soldiers With Post-Traumatic Headache
Article first published online: 3 SEP 2013
© 2013 American Headache Society
Headache: The Journal of Head and Face Pain
Volume 53, Issue 10, pages 1564–1572, November/December 2013
How to Cite
Rosenthal, J. F. and Erickson, J. C. (2013), Post-Traumatic Stress Disorder in U.S. Soldiers With Post-Traumatic Headache. Headache: The Journal of Head and Face Pain, 53: 1564–1572. doi: 10.1111/head.12200
Financial Support: This study was supported by the Comprehensive National Neuroscience Program at the Uniformed Services University of Health Sciences, Bethesda, MD, USA.
Disclaimer: The views expressed are those of the authors and are not the official policies of the Department of the Army, the Department of Defense, or the U.S. Government.
- Issue published online: 22 NOV 2013
- Article first published online: 3 SEP 2013
- Manuscript Accepted: 5 JUL 2013
- Comprehensive National Neuroscience Program at the Uniformed Services University of Health Sciences
- post-traumatic headache;
- post-traumatic stress disorder;
- mild traumatic brain injury
To determine the impact of post-traumatic stress disorder (PTSD) on headache characteristics and headache prognosis in U.S. soldiers with post-traumatic headache.
PTSD and post-concussive headache are common conditions among U.S. Army personnel returning from deployment. The impact of comorbid PTSD on the characteristics and outcomes of post-traumatic headache has not been determined in U.S. Army soldiers.
A retrospective cohort study was conducted among 270 consecutive U.S. Army soldiers diagnosed with post-traumatic headache at a single Army neurology clinic. All subjects were screened for PTSD at baseline using the PTSD symptom checklist. Headache frequency and characteristics were determined for post-traumatic headache subjects with and without PTSD at baseline. Headache measures were reassessed 3 months after the baseline visit, and were compared between groups with and without PTSD.
Of 270 soldiers with post-traumatic headache, 105 (39%) met screening criteria for PTSD. There was no significant difference between subjects with PTSD and those without PTSD with regard to headache frequency (17.2 vs 15.7 headache days per month; P = .15) or chronic daily headache (58.1% vs 52.1%; P = .34). Comorbid PTSD was associated with higher headache-related disability as measured by the Migraine Disability Assessment Score. Three months after the baseline neurology clinic visit, the number of subjects with at least 50% reduction in headache frequency was similar among post-traumatic headache cases with and without PTSD (25.9% vs 26.8%).
PTSD is prevalent among U.S. Army soldiers with post-traumatic headache. Comorbid PTSD is not associated with more frequent headaches or chronic daily headache in soldiers evaluated at a military neurology clinic for chronic post-traumatic headache. Comorbid PTSD does not adversely affect short-term headache outcomes, although prospective controlled trials are needed to better assess this relationship.