Robbins MS et al. – In this clinic–based cross–sectional study, episodic cluster headache (ECH) and chronic cluster headache (CCH) patients had similarly low rates of depression and anxiety. Rates were lower than those reported for both episodic and chronic migraine.

• Sociodemographics, comorbidities, and selected headache features were ascertained from a clinic–based sample in a cross–sectional fashion from January 2007 to July 2010.
• Active depression and anxiety were assessed using the Patient Health Questionnaire (PHQ–9) and the Generalized Anxiety Disorder 7–item (GAD–7) scales.

• Of 49 CH patients, ECH patients (n = 32) had an earlier age of onset and consumed less caffeine than CCH patients (n = 17).
• Rates of depression as defined by a PHQ–9 score ≥10 were low in both ECH (6.3%) and in CCH (11.8%) with similar mean PHQ–9 scores (3.1 vs 3.7, P = .69).
• Rates of anxiety as defined by a GAD–7 score ≥10 were also low in both ECH (15.6%) and CCH (11.8%) with similar mean GAD–7 scores (3.8 vs 3.4, P = .76).
• ECH patients in and out of active attack periods had similar levels of depression and anxiety.
• Depression and anxiety usually occurred together in ECH and CCH patients.
• CH patients who were depressed or anxious were more likely to present at a younger age and have attack–related nausea and prodromal symptoms.
• Depressed CH patients were also more likely to have another pain disorder and had undertaken twice as many prophylactic medication trials.