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.
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.

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    ABSTRACT: We sought to examine the relationship of family history of headache and family history of psychiatric disorders on self-reported health care utilization tendencies for migraine treatment. Familial aggregation of both migraine and depression has been well established in the literature. Family history of headache and psychiatric disorders could influence health care utilization tendencies for migraine. This is a secondary analysis of patients with severe migraine (n = 225) who answered questions about their family history, previous headache treatment history, disability (Headache Disability Inventory), and psychiatric symptoms (Beck Depression Inventory and Beck Anxiety Inventory). Using regression, we examined the relationship between family history of headache, depression, and anxiety and reported headache-related health care utilization. Participants reported family histories of headache (67.6%), anxiety (15.6%), and depression (29.3%). Participants reported seeing a physician for headache an average of 3.1 (standard deviation = 3.8) times in the past 2 years. In a 2-year period, 27.6% of participants reported seeing a general practitioner and 18.5% of participants reported seeing a neurologist. Twenty-eight percent of participants went to urgent care for headaches at least once in the last 2 years. Thirty-nine percent of participants reported using non-pharmacologic treatment for headache in the prior 2 years, with the highest rates of chiropractic manipulation (27.1%) and massage (18.2%), and fewest rates of biofeedback (0.4%), relaxation training (4.4%), psychotherapy (1.8%), physical therapy (4.9%), or acupuncture (1.8%). Family history of anxiety was associated with trying non-pharmacologic treatments for headache, but no other self-reported health care utilization variable. However, neither family history of headache nor family history of depression was associated with self-reported health care utilization tendencies. Headache Disability Inventory was associated with self-reported non-pharmacologic treatments for headache. Family history of anxiety, but not depression, was associated with utilizing non-pharmacologic treatments for headache. Also, disability was associated with utilizing non-pharmacologic treatments for headache. However, participants reported low rates of utilization for non-pharmacologic treatments with grade-A evidence.
    Headache The Journal of Head and Face Pain 02/2014; · 2.94 Impact Factor
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    ABSTRACT: The primary goal of this study was to evaluate the incidence and characteristics of posttraumatic headache attributed to mild brain injury in military personnel in Iran within a prospective and observational study design.
    Environmental Health and Preventive Medicine 09/2014;
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    ABSTRACT: Background Although anxiety and depression have been classified as distinct traits of affective disorders, previous studies have reported their co-occurrence in subjects with migraine. However, few reports are available on the clinical implications of this comorbidity. This study is to assess the comorbidity of anxiety and depression in subjects with migraine and its clinical implications in a population-based sample from Korea.Methods We selected Korean subjects aged 19¿69 years by the stratified random sampling method, and evaluated them using a semi-structured interview, designed to identify headache type, anxiety, and depression. We used Goldberg Anxiety Scale questions and Patient Health Questionnnaire-9 for the diagnosis of anxiety and depression, respectively.ResultsOf the 2,762 participants who completed the interview, 147 subjects (5.4%) were classified as having a migraine during the previous year. Among these 147 subjects, 17 (11.6%) had anxiety and depression, 28 (19.0%) had anxiety alone, 9 (6.1%) had depression alone, and 93 (63.3%) had neither anxiety nor depression. Headache frequency per month was remarkably higher in subjects having migraine with anxiety and depression (median [25¿75 percentile values], 8.0 [2.5¿21.0]) than in those having migraine with anxiety alone (2.0 [1.0¿5.0], p¿=¿0.003), migraine with depression alone (1.0 [0.3¿4.0], p¿=¿0.001), and migraine without anxiety or depression (1.0 [0.3¿3.0], p¿<¿0.001). The migraine with anxiety alone (7.0 [6.0¿8.0], p¿=¿0.011) group and migraine with anxiety and depression (7.0 [5.0¿9.0], p¿=¿0.018) group showed higher Visual Analogue Scale scores for pain intensity compare to migraine without anxiety or depression (6.0 [5.0-7.0]) group.Conclusions Approximately 1/3 of migraineurs with anxiety had depression and 2/3 of migraineurs with depression had anxiety. Combination of anxiety and depression was associated with an increased headache frequency. Anxiety was associated with exacerbation of headache intensity.
    BMC Neurology 12/2014; 14(1):238. · 2.49 Impact Factor