In primary headaches, mainly migraine, psychiatric comorbidities are important because they can potentially impact the clinical course, quality of life, and headache management negatively. Previous studies have shown that CH patients can have psychiatric comorbidities such as anxiety and depression . In addition, depressive symptoms can influence disease burden . However, whether the risk of anxiety and depression differs according to the status of the cluster headaches (active bout vs. remission) has not been investigated in detail to date. In addition, in a subset of CH patients ranging from 10.0% to 16.7%, migraine has been reported to coexist. Given the well-recognized link between migraine and psychiatric comorbidities, coexisting migraine may independently influence the risk for anxiety and depression in CH patients, although this is a relatively unexplored area to date.