Headache and fibromyalgia

The aim of this study was to analyze the types of headaches accompanying fibromyalgia and their course. We also compared the psychopathological profile of patients with fibromyalgia and headaches with patients with headaches but without fibromyalgia. We studied 43 women with fibromyalgia and headache diagnosed at the rheumatology unit following the American College of rheumatology criteria. All these patients underwent a structured interview with a neurologist who applied the diagnostic criteria of the International Headache Society to determine the type of headache present with fibromyalgia, and the antecedents and course of the headaches. These patients also answered the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and the Symptom Check list (SCl-90-r) questionnaires administered by a psychologist. We compared the psychopathological profile of this group with 30 women of similar age and educational level who complained of chronic headache but did not have fibromyalgia. our results showed that the type of headache in the fibromyalgia group was chronic tension type or migraine, each in about 50% of patients, and 25% of patients had a combination of both; 51% of patients had chronic headache together with the fibromyalgia; 67% had antecedents of episodic headache, mainly migraine (56%), that became chronic coinciding with the diagnosis of fibromyalgia. Headache did not change with the appearance of fibromyalgia in only 18.6% of patients. Comparison of the two groups showed that patients with fibromyalgia and headache had significantly higher scores related to anxiety, depression, somatization, and obsession than patients with chronic headache without fibromyalgia. our results support the notion that chronic headache and fibromyalgia, at least from a clinical viewpoint, share common mechanisms in function of their parallel course and a similar psychological profile, although scores are higher in fibromyalgia.