Patients with symptoms of anxiety and depression experienced higher migraine frequency, according to findings published in Headache.
“The association of depression and anxiety with headache depends more on headache frequency than diagnostic category (eg, migraine or tension-type headaches). However, the linear correlation between migraine frequency and mood/anxiety disorders is still not clear,” Hsuan-Te Chu, MD, from the department of psychiatry at Tri-Service General Hospital in Taiwan, and colleagues wrote. “There may be a bidirectional association between depression, migraines and headache characteristics, including frequency, as these factors tend to have a strong influence on anxiety and depression symptoms, as well as on quality of life.”
To determine whether migraine frequency is predictive of depression and anxiety symptoms, researchers examined demographic and clinical data, including sleep characteristics, for 588 patients attending an outpatient headache clinic in Taiwan between June 2014 and May 2016. They stratified migraines by frequency per month —1 to 4 headache days (low frequency), 5 to 8 headache days (medium frequency), 9 to 14 (high frequency) headache days or more than 14 headache days (chronic) — and by presence of auras. According to the American Migraine Foundation, an aura indicates recurrent attacks of neurologic symptoms that last only minutes and are generally followed by a headache. Depression and anxiety symptoms were indicated by the Beck’s Depression Inventory (BDI) and Hospital Anxiety and Depression Subscales (HADS).
Analysis of patients’ depression and anxiety measurements showed scores were highest in those with chronic migraines and lowest in nonmigraine controls (P < .001). Both BDI and HADS scores were independently associated with high-frequency and chronic migraines, and with poor sleep quality. The association between anxiety and depression and migraine frequency was present among those who experienced auras and those who did not.
The researchers noted that factors like emotional distress and incidence of headache may influence each other through some common pathophysiological mechanism.
“Greater migraine frequency, with or without auras, is associated with increased symptom scores of anxiety and depression. Poor sleep quality ... was also found to be an independent predictor of more severe depression and anxiety symptoms,” Chu and colleagues wrote. “Taken together, these findings suggest that preventive pharmacological treatments may reduce the risk of depression and anxiety problems in migraineurs.” – by Savannah Demko
Reference: American Migraine Foundation. Migraine and Aura. https://americanmigrainefoundation.org/understanding-migraine/migraine-and-aura/. Accessed on Oct. 25, 2017.
Disclosure: The study received partial grant support from the Ministry of Science and Technology of Taiwan and Tri-Service General Hospital.