| IHS | Diagnosis | ICD-10 |
|---|---|---|
| 12.2 | Headache attributed to psychotic disorder [code to specify aetiology] | R51 |
| Previously used terms | Delusional headache | |
Diagnostic criteria:
- Headache, no typical characteristics known, fulfilling criteria C-E
- Delusional belief about the presence and/or aetiology of headache1 occurring in the context of delusional disorder, schizophrenia, major depressive episode with psychotic features, manic episode with psychotic features or other psychotic disorder fulfilling DSM-IV criteria
- Headache occurs only when delusional
- Headache resolves when delusions remit
- Headache is not attributed to another cause
Note:
- For example, a patient's false conviction that he or she has a brain tumour or intracranial mass giving rise to headache, which would fulfil DSM-IV criteria for Delusional disorder, somatic type.
Comments:
Delusions, as defined in DSM-IV, are false fixed beliefs based on incorrect inference about reality that are firmly held despite obvious proof to the contrary. Delusions, like any firmly-held belief, can be about virtually anything. In 12.2 Headache attributed to psychotic disorder, the delusion specifically involves the presence of headache. In some instances, the delusion may involve a false belief that a serious medical condition (eg, brain tumour) is present and is the cause of the headache, despite repeated and appropriate authoritative reassurance that no such medical condition is present. In other cases, the content of the delusion may be more bizarre: for example, a delusion that a transmitter has been surgically implanted into one's head and that the transmitter is the cause of the headache.
Delusional headache is apparently very rare and no empirical data are available about this condition.
