Depression, anxiety are linked to migraine-related disability risk

  • Lipton RB & al.
  • Headache
  • 1 Sep 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Migraine-related disability is significantly more common among patients who also have a history of depression, anxiety, or both.
  • Depression affects almost one-third of patients with migraine, and anxiety affects almost a quarter. 
  • Both conditions are more common among patients with chronic migraine.

Why this matters

  • Interventions targeting psychiatric comorbidities may reduce disability among patients with migraine.

Study design

  • Subanalysis of the longitudinal, Internet-based Chronic Migraine Epidemiology and Outcomes Study.
  • 16,788 patients with a history of migraine.
  • Funding: Allergan, pre-AbbVie.

Key results

  • 91.2% had episodic migraine and 8.8% had chronic migraine.
  • 32.3% of participants had depression and 29.9% had anxiety.
  • 9.6% of participants had depression only, 7.2% anxiety only, 22.7% both depression and anxiety, and 60.5% neither.
  • Patients with chronic migraine were significantly more likely to have depression (56.6% vs 30.0%; P<.001 and anxiety vs p than those with episodic migraine.>
  • Patients with episodic migraine were more likely to have neither depression nor anxiety (62.7% vs 36.9%; P<.001>
  • After multivariable analysis, risk (rate ratios) of migraine-related disability was significantly higher in those with:
    • Depression alone: 1.56 (P<.001>
    • Anxiety alone: 1.39 (P<.001>
    • Depression and anxiety together: 1.79 (P<.001>

Limitations

  • Participants were mostly women (74.4%) and White (84.0%).