Effects of depression, anxiety and sleep disturbances on the quality of life in patients with episodic and chronic migraine

Abstract

Episodic and especially chronic headaches are associated with depression, anxiety and sleep disturbances, and have significant negative impact on health-related quality of life (QOL). We included 112 patients (78.6 % women) who completed self-report questionnaires including the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Migraine-Specific Quality of Life (MSQoL) and Insomnia Severity Index (ISI). We used multiple regression analyses to establish QOL predictors and compared patients with anxiety, depression and SD to those without. Among 112 patients, 34 (30.4%) had chronic migraine (CM) while 68 (69.6%) had episodic migraine (EM). Depression, anxiety and sleep disturbances were more common in CH than in EH (58 % vs. 32 %, p < 0.0001). Patients with CM had more serious clinical and very poor QOL than patients with EM. The strongest predictor of the MSQoL score in all patients with migraine was the BDI score (β = 0.382, p < 0.001), followed by the ISI score (β = 0.324, p = 0.005), BAI score (β = 0.212, p < 0.001). Next came female gender (β = 0.184, p < 0.001), headache intensity (β = 0.166; p < 0.001), and attack duration (β = 0.148; p = 0.001). BDI, ISI BAI scores and headache features (intensity and duration) had a direct effect on the QOL. Sleep disturbances and psychiatric comorbidities such as depression and anxiety have a significant effect on quality of life in patients with EH and CH. Improved complex treatment approaches are needed to decrease disability on the personal and social level in these patients.