Establishing the frequency of depression and the foresighted characteristics of depression among the patients admitted to the emergency department with the complaint of headache

INTRODUCTION AND THE OBJECTIVE: It is believed that the incidence of depression is higher among the patients who admitted to the emergency department with the complaint of headache compared to normal population. Here in this study, we aimed to establish the frequency of depression and the foresighted characteristics of depression among the patients admitted to the University of Dokuz Eylül, School of Medicine, and department of adult emergency medicine with the complaint of headache. MATERIALS AND METHODS: This study was carried out prospectively and cross-sectionally among the patients with the complaint of headache and meeting the criteria of the study, in the University of Dokuz Eylül, School of Medicine, department of adult emergency medicine, between December 01, 2017 and March 01, 2018. Data recording and evaluation form, "visual analog scale", and the "Beck's depression inventory" were used for the collection of patients data. The scale was realized by the patient him or herself with self-determination method. Among the patients with headache, sex, age, level of education, marital status, occupation, type of pain, charecteristic of pain, duration of pain, the frequency of admission to emergency department, the frequency of using painkiller drugs, the time of onset of pain and the time of emergent admisison with pain, the response to painkillers, the additional diseases, the relationship between the presence of factors that trigger the onset of headache, sleeping problems, psychiatric drug use in the last month, the presence of another psychiatric illness, and self-hash story and depression were all examined. Relation between criteria was evaluated at 95% confidence interval and accepted as p <0,05 statistical significance level. All statistical analyzes were performed with SPSS 22.0 (SPSS Inc.) program. RESULTS: Totally, 273 patients, with the mean age of 18-85 was participated in our study and while 56 % of them was female, the rest was male (44%). The rate of depression was detected as 56 %, among the 273 patients who participated in the study. While, 8,4 % (n=23) of them were severe depression, 17,6 % (n=48) was modarate-severe and 30 % (n=82) of them were mild depression. The average age of depressed individuals was 37 ± 13.8 years. Depression was detected in 60.8 % (n= 93) of the women and 50 % (n=60) of the males. No statistically significant difference was detected on behalf of educational status, marital status, job, frequency of depression among the individuals. The frequency of depression among the patients in whom the pain lasts up to 24 hours was found to be increased compared to lasts up 1 hour or 6 hours.. (% 78,0 versus % 53,3 and % 50,0 p:0,019) No statistically significant difference was detected between type of headache, time of onset, emergency department admission time and frequency of depression. People who used painkiller medication every day had a higher prevalence of depression than those who used it on alternate days or severel times a mount or never (% 72,7 versus %59,6, %45,0 and %60,2 p:0,023). The rate of depression was higher among the patients who admitted to emergency department 1-3 times a compared to patients who admitted with the frequency of 1-3 / month or less (82,6 versus % 53,6 p:0,007). Additional disease in individuals with headache there was a significantly higher rate of depression compared to non-group. (% 63,6 versus % 47,7 p: 0,008) The rate of depression in individuals with hypertension was found to be higher than migraine and other comorbid diseases. (% 69,2 versus % 65,5 and % 59,3 p:0,048) Rates of depression in individuals with sleep problems were significantly higher than those without sleep problems. (% 68,8 versus % 49,4 p:0,002) The depression rate was higher in the last month than in those who did not use anti-depressant-antipsychotic medication. (%88,2 versus %11,8 p: 0,02) The rates of depression in those with other psychiatric illness stories were higher than those without.(% 91,7 versus %52,6 p<0,001) VAS in depressed individuals was found to be significantly lower than those without (p<0,001). CONCLUSION: In this study, we investigated the relationship between the headache and the individuals who applied to the emergency service, depression in those who had long headache, frequent emergency services with the same complaints, less treatment response, other psychiatric illnesses, additional illnesses, sleep problems and those who did not use psychiatric drugs in the last month we found that the ratio increased. When assessing patients with headache, these predictive characteristics of depression should be considered. Patients showing these characteristics should be directed to psychiatric outpatient clinics for diagnosis and treatment of depression. Key Words: Emergency medicine, Headache, Depression