Anxiety and depression associated with migraine: Influence on migraine subjects' disability and quality of life, and acute migraine management

Department of Evaluation and Treatment of Pain, University Teaching Hospital, Hospital Pasteur, 06602 Nice, France.
Pain (Impact Factor: 5.84). 12/2005; 118(3):319-26. DOI: 10.1016/j.pain.2005.09.010
Source: PubMed

ABSTRACT Anxiety and depression are reported to be frequently associated with migraine but how they impact on migraine-related disability, migraine subjects' quality of life, and medical and therapeutic management of migraine attacks has not been investigated. FRAMIG 3 is a nation-wide population-based postal survey carried out in France according to the 2004 international classification of headache disorders. Subjects who had had migraine attacks during the last 3 months (subjects with 'active migraine', N = 1957) were analysed for migraine-related disability (MIDAS score), quality of life (SF-12 questionnaire), and anxiety and depression (Hospital Anxiety and Depression Scale [HADS]) in comparison with non-migraine subjects (N = 8287). Survey results indicate that 50.6% of subjects with active migraine were anxious and/or depressive (28.0% had anxiety alone, 3.5% depression alone, and 19.1% both anxiety and depression; P < or = 0.01 versus non-migraine subjects for anxiety alone and combined anxiety and depression, NS for depression alone). Although, migraine-associated anxiety and depression do not appear to influence the drugs taken by migraine subjects for the acute treatment of migraine attacks, perceived treatment efficacy and satisfaction with treatment are lower in subjects with anxiety alone or combined with depression than in subjects with neither anxiety nor depression. Anxiety and depression should be systemically looked for and cared for in subjects consulting for migraine.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Migraine is frequently comorbid with major depressive disorder, the presence of which confers increased disability and various clinical challenges. The present article reviews empirically supported pharmacologic and cognitive-behavioral interventions for depression, as well as the emerging yet generally mixed efficacy for various complementary and alternative medicine depression treatments. Clinical implications and treatment strategies for migraine patients with comorbid depression are discussed. The literature reviewed here draws together clinical practice options for clinicians. © 2015 American Headache Society.
    Headache The Journal of Head and Face Pain 02/2015; 55(2). DOI:10.1111/head.12521 · 3.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Migraine is a disabling and prevalent disorder. Migraine is most effectively treated with a stepped care approach, where patients initially receive a broad level of care (primary care) and proceed to receive increasingly specialized care throughout the course of treatment. Behavioral treatments for migraine modify behaviors of people with migraine with the intention to prevent migraine episodes and secondary consequence of migraine. Behavioral treatments can be incorporated into each level of the stepped care approach for migraine treatment. In this article, we provide a rationale for including behavioral treatment strategies in the treatment of migraine. We then describe and review the evidence for behavioral treatment strategies for migraine, including patient education, relaxation strategies, biofeedback, and cognitive behavioral treatment strategies. Finally, we describe how behavioral treatments can be integrated into a stepped care approach for migraine care.
    Current Neurology and Neuroscience Reports 04/2015; 15(4):533. DOI:10.1007/s11910-015-0533-5 · 3.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Omega-3 and omega-6 fatty acids are precursors of bioactive lipid mediators posited to modulate both physical pain and psychological distress. In a randomized trial of 67 subjects with severe headaches, we recently demonstrated that targeted dietary manipulation-increasing omega-3 fatty acids with concurrent reduction in omega-6 linoleic acid (the H3-L6 intervention)-produced major reductions in headache compared with an omega-6 lowering (L6) intervention. Because chronic pain is often accompanied by psychological distress and impaired health-related quality of life (HRQOL), we used data from this trial to examine whether the H3-L6 intervention favorably impacted these domains. Additionally, we examined the effect of the interventions on the number of cases with substantial physical or mental impairments as defined by cutoff values in the Brief Symptom Inventory (BSI-18), Medical Outcomes Study Short Forms 12 (SF-12), Headache Impact Test (HIT-6), and the number of headache days per month. In the intention-to-treat analysis, participants in the H3-L6 group experienced statistically significant reductions in psychological distress (BSI-18 mean difference: -6.56; 95% confidence interval [CI]: -11.43 to -1.69) and improvements in SF-12 mental (mean difference: 6.01; 95% CI: 0.57 to 11.45) and physical (mean difference: 6.65; 95% CI: 2.14 to 11.16) health summary scores. At 12 weeks, the proportion of subjects experiencing substantial impairment according to cutoff values in the BSI-18, SF-12 physical, HIT-6, and headache days per month was significantly lower in the H3-L6 group. Dietary manipulation of n-3 and n-6 fatty acids, previously shown to produce major improvements in headache, was found to also reduce psychological distress and improve HRQOL and function.
    Pain 04/2015; 156(4). DOI:10.1097/01.j.pain.0000460348.84965.47 · 5.84 Impact Factor