Migraine and greater pain symptoms at 10-year follow-up among patients with major depressive disorder

Ching-I Hung,Chia-Yih Liu,Shuu-Jiun Wang,Ching-Hui Yang

doi:10.1186/s10194-018-0884-9

Abstract

BackgroundNo study has investigated the associations of migraine with pain symptoms over a ten-year period among outpatients with major depressive disorder (MDD). This study aimed to investigate this issue.MethodsAt baseline, the study enrolled 290 outpatients with MDD and followed-up the patients at six-month, two-year, and ten-year time points. MDD and anxiety comorbidities were diagnosed using the Structured Clinical Interview for DSM-IV-text revision. Migraine was diagnosed based on the International Classification of Headache Disorders. The bodily pain subscale of the Short Form 36 (SF-BP) and the pain subscale (PS) of the Depression and Somatic Symptoms scale were also used. Generalized Estimating Equation models were employed to investigate the longitudinal impacts of migraine on pain symptoms.ResultsMDD patients with migraine had lower SF-BP and higher PS scores than those without. Depression, anxiety, and headache indices were significantly correlated with SF-BP and PS scores. The higher the frequency of migraine, the more often patients suffered from pain symptoms. Patients with migraine at all investigated time points suffered from pain symptoms most of the time (ranging from 60.0% to 73.7%) over the 10 years. After controlling for depression and anxiety, migraine was independently associated with a decreased SF-BP score (by 8.93 points) and an increased PS score (by 1.33 points).ConclusionMigraine was an important comorbidity associated with greater severities of pain symptoms during long-term follow-up. Migraine treatment should be integrated into the treatment of depression to improve pain symptoms and quality of life in the pain dimension.

Highlights

No study has investigated the associations of migraine with pain symptoms over a ten-year period among outpatients with major depressive disorder (MDD)
There were no significant differences between patients who were and were not followed-up at the three follow-up points in terms of the five demographic variables, with the exception of the variable of age at the ten-year follow-up point
At the six-month and two-year time points, the percentage of subjects who attended follow-up was over 80%

Summary

Introduction

No study has investigated the associations of migraine with pain symptoms over a ten-year period among outpatients with major depressive disorder (MDD). Major depressive disorder (MDD) and pain symptoms may have a shared neurobiological mechanism and may be genetically correlated [3, 4]. Among patients with MDD, pain symptoms are common, and are associated with a greater severity of depression, a poorer treatment response, inability to achieve full remission, impaired function, a poorer quality of life, and an increased suicidal risk [3, 5,6,7,8,9]. Among patients with chronic migraine, a higher affective dysregulated temperament score was found to be associated with a greater feeling of hopelessness and a higher suicidal risk [13]. Migraine is associated with increased risks of other diseases, such as cardiovascular diseases, cerebrovascular diseases, and fibromyalgia [15,16,17,18,19]

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