Clinical Scales for Psychiatric Comorbidities and Cognitive Processes in Headache and Migraine.

Primary headache patients, especially migraineurs, often present psychiatric comorbidities or cognitive impairment. Most frequent psychiatric comorbidities include major depression, anxiety, panic disorder, posttraumatic stress disorder (PTSD), or suicidal behaviour, while most dysfunctional cognitive domains usually are processing speed, memory, executive functions, and verbal skills. Both the presence of psychiatric comorbidities and cognitive impairment in migraine patients seems to be bidirectional. Theories regarding the association with psychiatric comorbidities consider mutual causality, latent brain state models, shared environment, and shared genetic origins. Dysfunctional cognitive styles can lead to chronification of headache or decreased response to pharmacological treatment by influencing patients’ behavior in interictal phases. The awareness of the presence of psychiatric comorbidities or cognitive impairment in migraine patients is fundamental for their management. We described widely used validated instruments to evaluate presence or severity of psychiatric comorbidities and to assess cognitive status and cognitive aspects in pain processing in migraine. Instruments are Minnesota Multiphasic Personality Inventory, My Mood Monitor checklist, Generalized Anxiety Disorder-7, Beck Anxiety Inventory, Beck Depression Inventory, Patients Health Questionnaire (PHQ), PHQ-4, PTSD Checklist-Civilian Version, Primary Care-PTSD Screen, Subjective Cognitive Impairments Scale, Headache-Specific Locus of Control Scale, Brief Illness Perception Questionnaire, Pain Catastrophizing Scale, and Headache Management Self-Efficacy Scale.