Hung Ching-I, Wang Shuu-Jiun, Yang Ching-Hui, Liu Chia-Yih
Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
J Psychosom Res. 2008 Aug;65(2):135-42. doi: 10.1016/j.jpsychores.2008.04.011.
Our purpose was to determine if migraine, anxiety comorbidities, and chronic depression were independently related to health-related quality of life (HRQoL) in outpatients with major depressive disorder (MDD).
Consecutive psychiatric outpatients with MDD in a medical center were enrolled. MDD, chronic depression, and seven anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. Migraine was diagnosed based on the International Classification of Headache Disorders, 2nd edition. The acute version of the Short-Form 36 and the Hamilton Depression Rating Scale (HAMD) were used to evaluate the HRQoL and the severity of depression, respectively. Multiple linear regressions were used to determine the independent factors related to HRQoL.
There were 135 participants (34 men, 101 women) with MDD. Subjects with migraine, anxiety comorbidities, or chronic depression had higher HAMD scores and poor HRQoL. Migraine, specific phobia, and panic disorder were important and independent comorbidities predicting HRQoL. The impact of migraine on HRQoL, especially on bodily pain, was not inferior to those of some anxiety comorbidities or chronic depression.
Future studies related to HRQoL of MDD should consider migraine and anxiety comorbidities simultaneously.
我们的目的是确定偏头痛、焦虑共病和慢性抑郁是否与重度抑郁症（MDD）门诊患者的健康相关生活质量（HRQoL）独立相关。
招募了一家医疗中心连续的患有MDD的精神科门诊患者。使用DSM-IV-TR的结构化临床访谈来诊断MDD、慢性抑郁和七种焦虑症。偏头痛根据《国际头痛疾病分类》第二版进行诊断。分别使用简明健康调查问卷36项急性版和汉密尔顿抑郁量表（HAMD）来评估HRQoL和抑郁严重程度。采用多元线性回归来确定与HRQoL相关的独立因素。
有135名患有MDD的参与者（34名男性，101名女性）。患有偏头痛、焦虑共病或慢性抑郁的受试者HAMD评分更高且HRQoL较差。偏头痛、特定恐惧症和惊恐障碍是预测HRQoL的重要且独立的共病。偏头痛对HRQoL的影响，尤其是对身体疼痛的影响，并不亚于某些焦虑共病或慢性抑郁。
未来与MDD的HRQoL相关的研究应同时考虑偏头痛和焦虑共病。
