Abstract

BackgroundFew studies have investigated the associations of comorbid migraine with other painful physical symptoms (PPS) in patients with major depressive disorder (MDD) at the two-year follow-up point. This study aimed to investigate this issue.MethodsAt baseline, 155 outpatients with MDD were enrolled. Migraine was diagnosed at baseline according to the International Classification of Headache Disorders. At follow-up, data of 101 subjects were analyzed. The average intensities of head, bone and/or joints, back, chest, abdomen, neck and/or shoulder, general muscle, and limb pain in the past week were evaluated using a visual analog scale (VAS). At follow-up, active headache was defined as a score on the VAS > 3. Multiple linear regressions were used to investigate the associations of migraine at baseline with other PPS at follow-up.ResultsCompared with the migraine with inactive headache group and the non-migraine group, patients with migraine with active headache had significantly higher intensities of other PPS and a lower remission rate of depression. There were no significant differences in the pain intensities of the other seven PPS between the migraine with inactive headache group and the non-migraine group. Headache intensity was significantly correlated with the intensities of other PPS at baseline and follow-up. Migraine with active headache independently predicted other PPS after controlling for depression and anxiety at baseline.ConclusionsMigraine with active headache among MDD patients could predict other PPS. Prevention and treatment of headache might help to decrease other PPS and improve the prognosis of depression. Integration of treatment for depression and headache is indicated.

Highlights

  • Among psychiatric outpatients with mood and/or anxiety disorders, painful physical symptoms (PPS) are common, and are associated with a higher severity of psychopathology [1]

  • There were no significant differences in the pain intensities of the other seven PPS between the migraine with inactive headache group and the non-migraine group

  • Headache intensity was significantly correlated with the intensities of other PPS at baseline and follow-up

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Summary

Introduction

Among psychiatric outpatients with mood and/or anxiety disorders, painful physical symptoms (PPS) are common, and are associated with a higher severity of psychopathology [1]. Among patients with major depressive disorder (MDD), PPS are common [4,5], and are associated with worse depression, an increased suicidal risk, functional impairment, a poorer quality of life, and a poorer treatment response [2,3,4,5,6]. Among patients with MDD, comorbidity with migraine was found to be related to greater severities of depression and anxiety, and had a negative impact on recovery of health-related quality of life post-pharmacotherapy [9,11,12,16]. Few studies have investigated the associations of comorbid migraine with other painful physical symptoms (PPS) in patients with major depressive disorder (MDD) at the two-year follow-up point.

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