2026 Volume 53 Issue 1 Pages 78-83
Headaches frequently co-occur with psychiatric conditions and are disproportionately reported in women. Among 2,525 outpatients at our psychiatric clinic, 360 (14.3%) had headache, of whom 73.9% were women. Among women whose headaches were managed in psychiatry, non-specific headache was the most frequent diagnosis. This practice-oriented review discusses (1) the epidemiology of headache in psychiatric outpatients, (2) women’s headache features across the life cycle and hormonal transitions, and (3) two illustrative cases: a woman in early pregnancy with chronic migraine and anxiety disorder who developed deep vein thrombosis, and a woman with hemiplegic migraine presenting as stroke mimic. In the first case, preconception psychotropic medication optimization and diagnostic overshadowing of somatic findings were key clinical issues; consultation-liaison psychiatry identified both pitfalls. In the second case, rapid psychiatric intervention for anxiety- and sensory hypersensitivity-related cognitive confusion contributed to clinical stabilization. We discuss the role of consultation-liaison psychiatry in women’s headache care and consider multidisciplinary collaboration informed by established perinatal liaison nursing frameworks.
