Comorbidity of Migraine and Depression – a Meta-analysis

Česká verzia

Authors: J. Kožený; C. Höschl; L. Tišanská
Authors place of work: Psychiatrické centrum Praha a 3. LF UK v Praze
Published in the journal: Cesk Slov Neurol N 2013; 76/109(6): 712-716
Category: Original Paper

Summary

The aim of the study:
The aim of our study was to support the supposition of an association between migraine and depression.

Methods:
We reviewed 20 population-based cross-sectional studies focused on migraine in association with depression. For meta-analysis, we used odds ratio (OR) and random effects models. In the search for sources of heterogeneity, we subdivided the studies on the basis of method of migraine and depression diagnosis, sampling, type of contact with subjects, and locality. The effect of proportional representation of females and sample size on OR variability was tested with meta-regression. Publication bias was verified by a funnel plot and by the Egger’s regression test.

Results:
Three times higher incidence of depressive symptomology is expected in migraineurs compared with non-migraineurs (OR = 3.11; 95% CI 2.43–3.98). The effect of potential moderators was, apart from the difference in OR between studies with direct and indirect contact (Q_dif = 6.32; p = 0.012), statistically insignificant. The OR variance was statistically significantly influenced by study size (Q_model = 5.07; df = 1; p = 0.027). There was no evidence for publication bias as tested by the visual inspection of the funnel plot and by Egger’s regression intercept (t = 1.92; df = 18; p = 0.10).

Conclusion:
The findings indicate strong comorbidity of migraine and depression. As depression is believed to be a risk factor for migraine chronification, monitoring of depressive symptomatology should be integral part of therapy.

Key words:
migraine – depression – meta-analysis

The authors declare they has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Zdroje

1. Raggi A, Giovannetti AM, Quintas R, D’Amico D, Cieza A, Sabariego C et al. A systematic review of the psychosocial difficulties relevant to patients with migraine. J Headache Pain 2012; 13(8): 595– 606.

2. Bruti G, Magnotti MC, Iannetti G. Migraine and depression: bidirectional co‑ morbidities? Neurol Sci 2012; 33 (Suppl 1): S107– S109.

3. Atlas of headache disorders and resources in the world. Geneva: WHO 2011.

4. Manzoni GC, Lombardi LL, Lana S, Maffezzoni M,Camarda C, Tortelli P. Detection of possible factors favouring the evolution of migraine without aura into chronic migraine. Neurol Sci 2012; 33 (Suppl 1): S165– S167.

5. Zebenholzer K, Thamer M, Wöber C. Quality of life, depression, and anxiety 6 months after inpatient withdrawal in patients with medication overuse headache: an observational study. Clin J Pain 2012; 28(4): 284– 290.

6. UZIS ČR. Zdravotnická ročenka České republiky 2011 [on‑line]. Available from URL: http:/ / www.uzis.cz/ .

7. International Headache Society. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders. 2nd ed. Cephalalgia 2004; 24 (Suppl 1):9– 160.

8. International Headache Society. Headache Classification Committee. Proposed classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988; 8 (Suppl 7): 9– 96.

9. Baskin SM, Todd C, Smitherman A. Migraine and psychiatric disorders: comorbidities, mechanisms, and clinical applications. Neurol Sci 2009; 30 (Suppl 1): S61– S65.

10. Breslau N, Lipton RB, Stewart WF, Schultz LR, Welch KM. Comorbidity of migraine and depression: investigating potential etiology and prognosis. Neurology 2003; 60(8): 1308– 1312.

11. Breslau N, Davis GC. Migraine, physical health and psychiatric disorder: a prospective epidemiologic study in young adults. J Psych Res 1993; 27(2): 211– 221.

12. Breslau N, Davis GC, Schultz LR, Paterson LR. Migraine and major depression: a longitudinal study. Headache 1994; 34(7): 387– 393.

13. Breslau N, Schultz LR, Steward WF, Lipton RB, Lucia VC, Welch KM. Headache and major depression: is the association specific to migraine? Neurology 2000; 54(2): 308– 313.

14. Camarda C, Pipia C, Taglialavori A. Di Fiorer P, Camarda R, Monastero R. Comorbidity between depressive symptoms and migraine: preliminary data from the Zabút Aging Project. Neurol Sci 2008; 29 (Suppl 1):S149– S151.

15. Chen YC, Tang CH, Ng K, Wang SJ. Comorbidity profiles of chronic migraine sufferers in a national database in Taiwan. J Headache Pain 2012; 13(4): 311– 319.

16. Fernández‑ de‑ Las‑ Peñas C, Hernández‑Barrera V, Carrasco‑ Garrido P, Alonso‑ Blanco C, Palacios‑ Ceña D,Jiménez‑ Sánchez S et al. Population‑based study of migraine in Spanish adults: relation to socio‑ demographic factors, lifestyle and co‑ morbidity with other conditions. J Headache Pain 2010; 11(2): 97– 104.

17. Hung CI, Liu CY, Juang YY, Wang SJ. The impact of migraine on patients with major depressive disorder. Headache 2006; 46(3): 469– 477.

18. Jette N, Patten S, Williams J, Becker W, Wiebe S. Comorbidity of migraine and psychiatric disorders – national population‑based study. Headache 2008; 48(4): 501– 516.

19. Kalaydjian A, Merikangas K. Physical and mental comorbidity of headache in a nationally representative sample of US adults. Psychosomatic Med 2008; 70(7): 773– 780.

20. Kececi H, Dener S, Analan E. Co‑ morbidity of migraine and major depression in the Turkish population. Cephalalgia 2003; 23(4): 271– 275.

21. Lantéri‑ Minet M, Valade D, Géraud G, Chautard MH,Lucas C. Migraine and probable migraine – results of FRAMIG 3, a French nationwide survey carried out according to the 2004 IHS classification. Cephalalgia 2005; 25(12): 1146– 1158.

22. Lipton RB, Hamelsky SW, Kolodner KB, Steiner TR,Steward WF. Migraine, quality of life, and depression: a population‑based case‑ control study. Neurology 2000; 55(5): 629– 635.

23. Merikangas KR, Angst J, Isler H. Migraine and psychopathology. Results of the Zurich cohort study of young adults. Arch Gen Psychiatry 1990; 47(9): 849– 853.

24. Mitsikostas DD, Thomas AM. Comorbidity of headache and depressive disorder. Cephalalgia 1999; 19(4): 211– 217.

25. McWilliams LA, Goodwin RD, Cox BJ. Depression and anxiety associated with three pain conditions: results from a nationally representative sample. Pain 2004; 111(1– 2): 77– 83.

26. Oedegaard KJ, Neckelmann D, Mykletun A, Dahl AA,Zwart JA, Hagen K et al. Migraine with and without aura: association with depression and anxiety disorder in a population‑based study. The HUNT study. Cephalalgia 2006; 26(1): 1– 6.

27. Ratcliffe GE, Enns MW, Jacobi F, Belik SL, Sareen J. The relationship between migraine and mental disorders in a population‑based sample. Gen Hosp Psychiatry 2009; 31(1): 14– 19.

28. Samaan Z, Farmer A, Craddock N. Jones L. Korszun A, Owen M et al. Migraine in recurrent depression: case‑ control study, Brit J Psych 2009; 194(4): 350– 354.

29. Zwart JA, Dyb G, Hagen K, Ødegård KJ, Dahl AA, Bovim G et al. Depression and anxiety disorders associated with headache frequency. The Nord‑ Trøndelag Health Study. Eur J Neurol 2003; 10(2): 147– 152.

30. Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive Meta‑analysis Version 2. 2nd ed. New Jersey: Biostat 2005.

31. DerSimonian R, Laird N. Meta‑analysis in clinical trials. Control Clin Trials 1986; 7(3): 177– 188.

32. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‑analysis detected by a simple, graphical test. BMJ 1997; 315(7): 629– 634.

33. International Headache Society. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33(9): 629– 808.