Race, psychiatric comorbidity, and headache characteristics in patients in headache subspecialty treatment clinics

Objective. This research examined how race, psychiatric comorbidity, and headache characteristics are inter-related in patients with severe headache disorders. Design. This study used a naturalistic cohort design and assessed 114 Black and 173 White patients receiving treatment in headache subspecialty clinics in Cincinnati, Cleveland, Columbus, and Toledo, OH. Face-to-face interviews yielded headache and psychiatric diagnoses; 30-day daily diaries collected data on headache frequency, severity, and disability; and self-administered surveys obtained data on headache management self-efficacy, headache locus of control, and quality of life. Results. Compared with Whites, Blacks reported more frequent and severe headaches, were more likely to be diagnosed with depressive disorders, and were more likely to be diagnosed with chronic headaches. White and Black patients diagnosed with both depression and anxiety reported the most frequent headache days per month and the lowest levels of life quality and headache management self-efficacy. Conclusions. Additional research on race, psychiatric comorbidity, and headache characteristics is needed that can inform culturally contextualized interventions for persons with severe headache disorders.