Diagnostic criteria:
- Headache, no typical characteristics known, fulfilling criteria C-E
- Presence of major depressive disorder fulfilling DSM-IV criteria:
- one or more episodes in which, during the same 2-week period, at least five of the following symptoms are present:
- depressed mood
- markedly diminished interest or pleasure
- weight or appetite change
- insomnia or hypersomnia
- psychomotor agitation or retardation
- fatigue or loss of energy
- feelings of worthlessness or excessive or inappropriate guilt
- diminished ability to concentrate or indecisiveness
- recurrent thoughts of death, suicidal idea, plan or attempt
- occurring in the absence of any manic or hypomanic episodes
- not better accounted for by bereavement and not due to the direct physiological effects of a medical condition or substance
- one or more episodes in which, during the same 2-week period, at least five of the following symptoms are present:
- Headache occurs exclusively during major depressive episodes
- Headache resolves or greatly improves within 3 months after the major depressive disorder is in full remission
- Headache is not attributed to another cause
Comment:
Since tricyclic antidepressants are effective against certain types of headache, remission of headache is more suggestive of a psychiatric cause of the headache when major depressive disorder improves under treatment with other antidepressants than tricyclic antidepressants.

