Psychiatric comorbidities in allodynic migraineurs

Abstract

Objectives: To evaluate the prevalence and the association of psychological disturbance in migraine patients with allodynia.

Methods: We recruited 434 migraine patients from an outpatient clinic. The participants completed three self-administered questionnaires, including a headache questionnaire, an allodynia symptoms checklist, and the Hospital Anxiety and Depression Scale (HADS).

Results: Among the migraineurs, 48.4% participants reported allodynia. The HADS total score (15.5 ± 7.8 vs. 13.7 ± 8.5, P = 0.022) and anxiety subscore (9.1 ± 4.5 vs. 7.6 ± 4.7, P = 0.001) were higher in migraineurs with allodynia than in those without allodynia. The anxiety subscore in patients with moderate to severe allodynia, mild allodynia, and no allodynia were 10.0 ± 4.5, 8.4 ± 4.3, and 7.6 ± 4.7 ( P < 0.001, by one-way analysis of variance). Among patients with moderate to severe allodynia, there was a trend of higher depression subscore (7.1 ± 4.0, P = 0.059) than those with no (6.1 ± 4.4) or mild allodynia (5.8 ± 4.0). In a regression model, the presence of allodynia is an independent risk factor for clinically significant anxiety. Moderate to severe allodynia is an independent risk factor for clinically significant depression.

Conclusions: In migraineurs, the severity of cutaneous allodynia was associated with their mood status, especially anxiety.

Keywords: Depression; allodynia; anxiety; migraine.