Department of Neuroscience and Behavioral Science, School of Medicine at Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Headache. 2012 Mar;52(3):400-8. doi: 10.1111/j.1526-4610.2012.02095.x. Epub 2012 Feb 14.
Migraine is comorbid to depression and widespread chronic pain (WCP), but the influence of these conditions on the health-related quality of life (HRQoL) of individuals with episodic (EM) and chronic migraine (CM) is poorly understood.
To assess the prevalence of depressive symptoms and WCP in individuals with EM and CM, as well as to estimate the joint impact of these conditions on the HRQoL of these individuals.
All women aged 18 to 65 years with a first diagnosis of EM or CM from September of 2006 to September of 2008 seen in an outpatient headache service were invited to participate. They were asked to attend a separate appointment in the service, and to bring another woman of similar age that also agreed to participate. Depressive symptoms were assessed using the Beck Depression Inventory. Questions about WCP followed the protocol of the American College of Rheumatology. HRQoL was assessed using the Short-Form 36 (SF-36). Multivariate analysis modeled HRQoL as a function of headache status, depressive symptoms, and pain, using quantile regression.
Sample consisted of 179 women, 53 in the EM group, 37 in the CM group and 89 in control group. Groups did not differ by demographics. Mean scores of SF-36 were 53.6 (standard deviation [SD] = 23.5) for EM, 44.2 (SD = 18.5) for CM and 61.8 (SD = 21.5) for controls. In multivariate analysis, SF-36 scores were predicted by a CM status (P = .02; -10.05 [95% CI -18.52; -1.58]) and by a Beck Depression Inventory score (P < .01; -1.27 [95% CI -1.55; -0.99]). The influence of WCP in the SF-36 scores approached significance (P = .08; -0.78 [95% CI -1.64; 0.88]). Age did not contribute to the model.
Women with migraine are at an increased chance of WCP, and the chance increases as a function of headache frequency. Both depressive symptoms and CM independently predict HRQoL status.
偏头痛与抑郁和广泛慢性疼痛（WCP）共病，但这些疾病对发作性偏头痛（EM）和慢性偏头痛（CM）患者健康相关生活质量（HRQoL）的影响知之甚少。
评估 EM 和 CM 患者中抑郁症状和 WCP 的患病率，并估计这些疾病对这些患者 HRQoL 的联合影响。
2006 年 9 月至 2008 年 9 月在门诊头痛服务中首次诊断为 EM 或 CM 的所有 18 至 65 岁女性均被邀请参加。她们被要求在服务中预约另一个年龄相仿的女性参加。使用贝克抑郁量表评估抑郁症状。WCP 的问题遵循美国风湿病学会的方案。使用 36 项简短形式健康调查量表（SF-36）评估 HRQoL。使用分位数回归对多变量分析模型，将 HRQoL 作为头痛状况、抑郁症状和疼痛的函数进行建模。
样本包括 179 名女性，53 名在 EM 组，37 名在 CM 组，89 名在对照组。各组在人口统计学上无差异。EM 组 SF-36 的平均得分为 53.6（标准差[SD] = 23.5），CM 组为 44.2（SD = 18.5），对照组为 61.8（SD = 21.5）。在多变量分析中，SF-36 评分由 CM 状态预测（P =.02；-10.05[95%CI-18.52；-1.58]）和贝克抑郁量表评分预测（P <.01；-1.27[95%CI-1.55；-0.99]）。WCP 对 SF-36 评分的影响接近显著（P =.08；-0.78[95%CI-1.64；0.88]）。年龄对模型没有贡献。
偏头痛女性发生 WCP 的几率增加，且这种几率随头痛频率的增加而增加。抑郁症状和 CM 均可独立预测 HRQoL 状况。
