Concurrent Mood Disorders Impact Migraine Frequency, Duration of Attack

Examining the relationship between migraine and mood disorders, researchers have found the duration and frequency of migraine are associated with these disorders.

The study of more than 100 patients also found that concurrent mood disorders have an impact on migraine-related disability. These findings, according to the researchers, have important implications for the treatment of migraine because understanding a patient’s comorbidities allows for efficient and effective treatment.

Researchers identified the 133 patients visiting the Neurology Outpatient Department of a Tertiary CARE Hospital for headache between August 1, 2016, and February 28, 2017. Among the patients, the median duration of migraine was 6 years, with a mean of 6.6 years.

To determine if the patient also had concurrent anxiety or depression, the researchers used the Hospital Anxiety and Depression Scale, with a potential range of 0-21 for each of the 2 disorders. The mean score of depression was 11.25 while the mean score of anxiety was 13.82. Twelve (9.02%) patients were considered to exhibit depressive symptoms, 5 (41.7%) of which a borderline abnormal score, and 7 (58.3%) had an abnormal score. Among the 22 (16.54%) patients with anxiety, 4 (18.2%) had borderline scores and 18 (81.8%) had abnormal scores.

There was an observed correlation between mood changes and the frequency of migraine attacks. There was also an association between migraine duration and mood change, with increased migraine duration resulting in more severe mood changes. However, there was no association between mood changes and other characteristics of migraine, including the presence of aura, gender, age, and photophobia or phonophobia.

According to the researchers, 53 (40.3%) patients had moderate disability and 35 (26.1%) had severe disability. As the rate of disability increased, so did the severity of the mood changes.

The association between migraine and mood disorders could be multifactorial, according to the researchers. “Depressive symptoms and anxiety could emerge after recurrent headache episodes or by themselves they could be risk factors for migraine, and finally, they could be associated with some other confounding factor which drives the headache,” they wrote.

They added that the findings highlight the importance of testing patients with migraine for these mood disorders because untreated depression has been identified as a risk factor for low-frequency episodic migraine progressing to chronic migraine and both depression and anxiety are associated with poorer long-term migraine outcomes, higher medical costs, healthcare utilization, and increased migraine-related disability.

Reference:

Rammohan K, Mundayadan S, Das S, Shaji C. Migraine and mood disorders: prevalence, clinical correlations and disability. J Neurosci Rural Pract. doi: 10.4103/jnrp.jnrp_146_18.