{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:39:11Z","timestamp":1781563151541,"version":"3.54.5"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PCN Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Headache is one of the most frequent somatic complaints in psychiatric practice and is often attributed to underlying mental disorders. However, primary headache disorders\u2014particularly migraine and tension\u2010type headache (TTH)\u2014commonly coexist with psychiatric conditions. Evidence from psychiatric outpatient settings remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective chart review of all psychiatric outpatients who visited our 600\u2010bed regional general hospital between April 1, 2023, and March 31, 2024. Among 2525 patients, we identified 360 individuals with headache\u2010related insurance diagnoses and extracted data on headache labels, treating departments, and prescribed medications. For calcitonin gene\u2013related peptide (CGRP)\u2010targeted monoclonal antibodies, we extended the observation period to March 31, 2025, to describe an exploratory case series including additional prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 2525 psychiatric outpatients, 360 (14.3%) carried a headache\u2010related insurance diagnosis. The most frequent labels were \u201cheadache\u201d (203\/360, 56.4%), migraine (92\/360, 25.6%), and TTH (46\/360, 12.8%); cluster headache and medication\u2010overuse headache (MOH) were each recorded in 1\/360 (0.3%). Headache care was most often delivered within psychiatry (153\/360, 42.5%), followed by neurology (42\/360, 11.7%), neurosurgery (40\/360, 11.1%), general internal medicine (28\/360, 7.8%), and rheumatology\/collagen\u2010vascular disease (15\/360, 4.2%). Commonly documented agents included nonsteroidal anti\u2010inflammatory drug (NSAIDs) (40\/360, 11.1%), acetaminophen (38\/360, 10.6%), triptans (23\/360, 6.4%), Japanese Kampo formulas (16\/360, 4.4%), and CGRP monoclonal antibodies (6\/360, 1.7%). At the agent level, acetaminophen (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200938), loxoprofen (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933), zolmitriptan (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), goreisan (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), sumatriptan (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), kakkonto (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096), diclofenac (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), valproic acid (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), and naratriptan (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) were among the most frequently listed. In the exploratory CGRP analysis (total seven patients through March 31, 2025), six were women; the mean age was 48.4\u2009\u00b1\u20099.2 years. Psychiatric comorbidities were heterogeneous, including eating disorder, bipolar disorder, post\u2010traumatic stress disorder, dysthymia with social anxiety disorder, schizophrenia, autism spectrum disorder, and neurotic depression. All cases experienced headache improvement; two required switching to another CGRP agent for recurrent attacks yet maintained benefit. One patient temporarily discontinued due to a rash before resuming a different CGRP agent. In contrast, medium\u2010term changes in mood\/anxiety were limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a psychiatric outpatient cohort, primary headaches were common and frequently managed within psychiatry. CGRP\u2010targeted therapy yielded headache relief even under psychiatric comorbidity, while psychiatric symptoms did not uniformly improve, underscoring the need for parallel mental\u2010health interventions alongside headache\u2010specific care. Strengthening cross\u2010specialty pathways and early headache evaluation within psychiatry are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pcn5.70235","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T08:30:28Z","timestamp":1761813028000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Characteristics and management of headache among psychiatric outpatients at a Japanese general hospital: A retrospective study with an exploratory CGRP case series"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7395-8031","authenticated-orcid":false,"given":"Kyohei","family":"Otani","sequence":"first","affiliation":[{"name":"Department of Psychiatry Kakogawa Central City Hospital Kakogawa Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyasu","family":"Imbe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kakogawa Central City Hospital Kakogawa Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Shindo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kakogawa Central City Hospital Kakogawa Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2015-312233"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-021-01281-z"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165316"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-020-01599-0"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16106"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12030677"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-021-01333-4"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/03331024231222923"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2025.0806"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2009.01544.x"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-021-03428-3"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1436258"}],"container-title":["Psychiatry and Clinical Neurosciences Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pcn5.70235","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pcn5.70235","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pcn5.70235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T14:48:05Z","timestamp":1771166885000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pcn5.70235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/pcn5.70235"],"URL":"https:\/\/doi.org\/10.1002\/pcn5.70235","archive":["Portico"],"relation":{},"ISSN":["2769-2558","2769-2558"],"issn-type":[{"value":"2769-2558","type":"print"},{"value":"2769-2558","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"assertion":[{"value":"2025-09-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70235"}}