Migraine and Mood Disorders: Prevalence, Clinical Correlations and Disability

Abstract

Introduction: Both migraine and mood disorders are prevalent disorders with many studies demonstrating that they are comorbid with each other with increased migraine-related disability in such patients.

Aim: The aim of the study is to test the hypothesis that mood disorders are comorbid with migraine with increased disability and to identify any clinical features in migraineurs which may be associated with mood disorders.

Materials and methods: Patients presenting with complaints of headache to the Neurology Outpatient Department of a Tertiary CARE Hospital from August 01, 2016 to February 28, 2017, were subjected to International Classification of Headache Disorder 3 beta criteria to satisfy a diagnosis of migraine and were assessed in detail as to headache characteristics. Mood disorders were assessed by Hospital Anxiety and Depression Scale and migraine-related disability was assessed by Migraine Disability Assessment Questionnaire. Patients with serious medical complaints, known previous psychiatric disease, other types of headaches and recent prophylactic drug intake were carefully excluded.

Results: A total of 133 patients were studied. The duration and frequency of migraine headaches were found to correlate with the presence of mood disorders and the migraine-related disability in patients with comorbid mood disorders was significantly higher. Factors such as total duration of migraine, aura, vomiting, phono, and photophobia were not found to be statistically correlated with mood disorders.

Conclusions: Rates of depression and anxiety in migraine vary widely in various studies due to variations in study criteria, population characteristics and various scales used. We found a prevalence of 16.54% of anxiety and 9.02% of depression in migraineurs, a rate comparable to or less than many studies in international literature and a significantly increased disability in individuals with comorbid mood disorders and migraine. Routinely including questionnaires such as HAD in screening patients with migraine to rule out comorbid mood disorders may be warranted. Because we have carefully excluded all other primary (especially tension and medication overuse headaches) and secondary headaches and selected prophylactic drug naïve patients, we contend that this study provides a clear clinical profile of migraineurs with mood disorders.

Keywords: Comorbidity; meta-analysis; migraine; mood disorders.