Our findings indicate that IDA is significantly associated with PMM/MRM. Further research may determine whether the complex relationships between estrogen, iron metabolism, and dopamine dysfunction, and their effects on migraine, are underlying reasons for this association.

PURPOSEUp to 60% of people with epilepsy (PwE) have psychiatric comorbidity including anxiety.Anxiety remains under recognized in PwE. This study investigates if screening tools validated for depression could be used to detect anxiety disorders in PWE. Additionally it analyses the effect of anxiety on QoL. METHODS261 participants with a confirmed diagnosis of epilepsy were included. Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Emotional Thermometers (ET), both validated to screen for depression were used. Hospital Anxiety and Depression ScaleAnxiety (HADS-A) with a cut off for moderate and severe anxiety was used as the reference standard. QoL was measured with EQ5-D. Sensitivity, specificity, positive and negative predictive value and ROC analysis as well as multivariate regression analysis were performed. RESULTSPatients with depression (n=46) were excluded as multivariate regression analysis showed that depression was the only significant determinant of having anxiety in the group. Against HADS-A, NDDI-E and ET-7 showed highest level of accuracy in recognizing anxiety with ET7 being the most effective tool. QoL was significantly reduced in PwE and anxiety. CONCLUSIONSOur study showed that reliable screening for moderate to severe anxiety in PwE without comorbid depression is feasible with screening tools for depression. The cut off values for anxiety are different from those for depression in ET7 but very similar in NDDI-E. ET7 can be applied to screen simultaneously for depression and "pure" anxiety. Anxiety reduces significantly QoL. We recommend screening as an initial first step to rule out patients who are unlikely to have anxiety.Highlights  Moderate to severe anxiety is a frequent comorbidity in epilepsy, in our cohort prevalence was 26,4%  Depression was the only significant determinant for anxiety, prevalence of anxiety in non-depressed PwE was 15,8%. Screening for anxiety independent from depression can be achieved with the ET7 tool.

Antiepileptic drug treatment should be reviewed in patients reporting injuries in order to evaluate the potential contribution and burden of AED side effects.