Comorbid Migraine is Associated with a Negative Impact on Quality of Life in Patients with Major Depression

Abstract

This study investigated the impact of migraine on health-related quality of life (HRQoL) among patients with major depressive disorder (MDD). We prospectively enrolled 151 consecutive psychiatric out-patients meeting DSM-IV criteria for MDD. Migraine and other headache types were diagnosed based on the International Classification of Headache Disorders, 2nd edition (2004). The Short Form-36 (SF-36) was administered as a generic instrument of HRQoL. Among 151 patients with MDD, migraine (N = 73, 48.3%) was very common. Comorbidity of migraine predicted a significantly negative impact on all physical subscales and vitality but not on the other mental subscales of the SF-36 after controlling for depression, age and gender. The presence of migraine should be considered as an important physical symptom in clinic-based MDD samples. Simultaneous management of depression and severe headaches, especially migraine, might improve HRQoL in patients with MDD.

Precipitating or aggravating factors for headache in patients with major depressive disorder

“…This issue is worth emphasizing and investigating because MDD is a common disorder and is predicted to become the second leading cause of disability by the year 2020 [22]. Disability from a MDD partially results from severe headaches according to several previous studies [9,23].…”

“…Depression, anxiety, and headache are closely interrelated [1][2][3][4][5][6][7][8][9][10][11]. Depression and anxiety can worsen the prognosis of headache [1,2], increase headache frequency [3], raise the medical cost of headache treatment [4], and cause more somatic discomfort for headache patients [5][6][7].…”

“…Similarly, headache, especially migraine, can cause negative impacts on patients with major depressive disorder (MDD). MDD patients with migraine have more depressive episodes, irritability, anxiety, and somatic symptoms and a poorer quality of life, compared to those without migraine [8][9][10][11].…”

Psychiatric comorbidities and migraine chronification

“…Higher rates of 2-week disability, increased restriction of activities, and poorer quality of life were observed in Canadian migraineurs with comorbid depression, bipolar disorder, or an anxiety disorder compared to those with none or only one of these conditions [26•]. Similarly, Taiwanese outpatients with major depressive disorder were found to score lower on quality-of-life measures when they also suffered from migraine [27].…”

Pain and Depression in a Cohort of Underserved, Community-Dwelling Primary Care Patients

“…6,7 Pain and depression are mutually exacerbating, and their coexistence predicts a longer time to remission once treatment begins. 8 Primary care clinicians recognize that many pain syndromes are comorbid with depression, and common physical symptoms reported with depression include headaches (14%), 9 back pain, abdominal pain (15%), nonspecific chest pain (11%), and generalized muscle pain. 8,10 -12 Family physicians and other primary care clinicians find that up to 80% of depressed patients present to their practices with these physical symptoms.…”