Lieba-Samal D, Bartl S, Salhofer S, Prajsnar A, Massl R, Freydl E, Fathinia P, Wöber-Bingöl C, Wöber C
Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria.
Cephalalgia. 2009 Oct;29(10):1049-58. doi: 10.1111/j.1468-2982.2008.01838.x. Epub 2009 Mar 13.
The course of disease and the predictive value of depression and anxiety in patients with migraine were prospectively examined. We recruited 393 migraineurs through articles in newspapers and performed a follow-up examination 30 months later. At baseline and follow-up, patients underwent a semistructured interview, filled out the Headache Impact Test (HIT-6), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) and they kept a headache diary for 30 days. One hundred and fifty-one patients (38.6%) were seen at follow-up. The baseline data of patients with and without follow-up were comparable. At follow-up the number of headache days per month had decreased from 9.6 +/- 5.8 to 8.1 +/- 6.3 (P < 0.001) and the proportion of patients with chronic headache (15.4%) and medication overuse (13%) had remained stable. SDS and SAS scores were associated with a high migraine frequency and high initial SDS scores predicted high migraine frequency at follow-up. This longitudinal study in unselected patients with migraine not excluding subjects with chronic headache, medication overuse, depression or anxiety does not point towards migraine as a progressive disease in the vast majority of patients and confirms the importance of psychiatric comorbidity.
我们对偏头痛患者的疾病进程以及抑郁和焦虑的预测价值进行了前瞻性研究。我们通过报纸上的文章招募了393名偏头痛患者，并在30个月后进行了随访检查。在基线和随访时，患者接受了半结构化访谈，填写了头痛影响测试（HIT-6）、自评抑郁量表（SDS）和自评焦虑量表（SAS），并记录了30天的头痛日记。151名患者（38.6%）接受了随访。有随访和无随访患者的基线数据具有可比性。随访时，每月头痛天数从9.6±5.8天降至8.1±6.3天（P<0.001），慢性头痛患者比例（15.4%）和药物过度使用患者比例（13%）保持稳定。SDS和SAS评分与偏头痛高发作频率相关，初始SDS高分预测随访时偏头痛发作频率高。这项针对未选择的偏头痛患者（不排除慢性头痛、药物过度使用、抑郁或焦虑患者）的纵向研究表明，绝大多数患者的偏头痛并非进行性疾病，并证实了精神共病的重要性。
