Headache and major depression: Is the association specific to migraine? Neurology

Department of Psychiatry, Henry Ford Health System, Detroit, MI 48202-3450, USA.
Neurology (Impact Factor: 8.3). 02/2000; 54(2):308-13. DOI: 10.1212/WNL.54.2.308
Source: PubMed

ABSTRACT To examine the relationship between migraine and major depression, by estimating the risk for first-onset major depression associated with prior migraine and the risk for first migraine associated with prior major depression. We also examined the extent to which comorbidity with major depression is specific to migraine or is observed in other severe headaches.
Representative samples of persons 25 to 55 years of age with migraine or other severe headaches (i.e., disabling headaches without migraine features) and controls with no history of severe headaches were identified by a telephone survey and later interviewed in person to ascertain history of common psychiatric disorders.
Lifetime prevalence of major depression was approximately three times higher in persons with migraine and in persons with severe headaches compared with controls. Significant bidirectional relationships were observed between major depression and migraine, with migraine predicting first-onset depression and depression predicting first-onset migraine. In contrast, persons with severe headaches had a higher incidence of first-onset major depression (hazard ratio = 3.6), but major depression did not predict a significantly increased incidence of other severe headaches (hazard ratio = 1.6).
The contrasting results regarding the relationship of major depression with migraine versus other severe headaches suggest that different causes may underlie the co-occurrence of major depression in persons with migraine compared with persons with other severe headaches.

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    • "Furthermore, population-based and observational studies have shown an association between chronic pain/pain disorders and migraine , with significantly greater frequency in those with CM [10] [14]. Additionally, studies suggest that migraine is comorbid with affective disorders such as chronic fatigue [1] [54] [67], anxiety [12] [38] [48] [57], and depression [13] [78], with anxiety and depression having greater frequency among persons with CM compared to those with EM [10] [14]. "
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    ABSTRACT: The objective of this study was to evaluate the association between low and frequent low back pain and chronic migraine (CM) and chronic tension-type headache (CTTH) in a large, German population-based sample. Headaches were diagnosed according to International Classification of Headache Disorders-2 criteria and categorized according to frequency (episodic 1-14days/month or chronic ⩽15days/month) and headache type (migraine or TTH). We defined frequent low back pain as self-reported low back pain on ⩾15days/month. We calculated odds ratios and 95% confidence intervals (CI) using logistic regression analyses, adjusting for sociodemographic covariates. There were 5605 respondents who reported headache in the previous year, of whom 255 (4.5%) had Chronic Headache. Migraine was diagnosed in 2933 respondents, of whom 182 (6.2%) had CM. TTH was diagnosed in 1253 respondents, of whom 50 (4.0%) had CTTH. Among 9944 respondents, 6030 reported low back pain, of whom 1267 (21.0%) reported frequent low back pain. In adjusted models, the odds of having frequent low back pain were between 2.1 (95% CI 1.7-2.6) and 2.7 (95% CI 2.3-3.2) times higher in all episodic headache subtypes when compared to No Headache. The odds of having frequent low back pain were between 13.7 (95% CI 7.4-25.3) and 18.3 (95% CI 11.9-28.0) times higher in all chronic headache subtypes when compared to No Headache. Low and frequent low back pain was associated with CM and CTTH. Multiple explanations may contribute to the association of headache and back pain, including the notion that the neurobiology of chronic headache, independent of primary headache type, not only involves the trigeminal pain pathway, but is also a part of abnormal general pain processing.
    Pain 12/2012; 154(3). DOI:10.1016/j.pain.2012.12.010 · 5.84 Impact Factor
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    • "In epidemiological studies, depressed patients have shown a more than three-fold risk for migraine compared to non-depressed patients; likewise, migraineurs have shown a more than three-fold risk of depression compared to nonmigraine patients (Benzenhofer, 1994; Torelli and D'Amico, 2004). In addition, depression predicts first-onset migraine and migraine predicts first-onset depression (Breslau et al., 2000; Lewandowski and Palermo, 2009). This evidence suggests a bidirectional relationship between migraine and depression. "
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    Brain research 11/2011; 1424:9-19. DOI:10.1016/j.brainres.2011.09.048 · 2.83 Impact Factor
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    • "Completed suicide (Rafnsson, Olafsson et al. 2001) is known to occur more than expected in people with epilepsy. Likewise, the relationship between MA and depression (Breslau, Schultz et al. 2000) is bidirectional and suicide attempt (Breslau, Schultz et al. 2000) is associated with prevalent MA. Combined, these associations suggest a common underlying genetic or acquired brain dysfunction. "
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