- Any headache fulfilling criterion C
- Post-traumatic stress disorder (PTSD) has been diagnosed according to DSM-5 criteria
- The headache first developed after exposure to the trauma stressor and occurs exclusively in the context of other symptoms of PTSD1
- Not better accounted for by another ICHD-3 diagnosis2.
- For example, headache occurs upon exposure to reminders of the trauma.
- In particular, A12.3 Headache attributed to depressive disorder.
Exposure to actual or threatened death, serious injury or sexual violation may occur directly by experiencing the event, or it may occur indirectly: by witnessing the event; by learning that the event occurred to a close family member or friend; by experiencing repeated or extreme exposure to aversive details of the event (eg, first responders collecting human remains; police officers repeatedly exposed to details of child abuse). This is not true of exposure through electronic media, television, movies or pictures, unless this exposure is work-related.
Given the high rate of comorbid depression with post-traumatic stress disorder (PTSD), the diagnosis of A12.9 Headache attributed to post-traumatic stress disorder should be reserved for patients whose headache is not explained by comorbid depression (ie, cases of headache attributed to PTSD in patients without comorbid depression).