Ohio University, USA.
Cephalalgia. 2012 Apr;32(5):390-400. doi: 10.1177/0333102411436333. Epub 2012 Mar 9.
Mood and anxiety disorders are comorbid with migraine and commonly assumed to portend a poor response to preventive migraine therapies. However, there is little evidence to support this assumption.
We examined impact of a mood and/or anxiety disorder diagnosis using American Psychiatric Association Diagnostic and Statistical Manual criteria on response to the three preventative migraine therapies evaluated in the Treatment of Severe Migraine trial (n = 177): β-blocker, behavioral migraine management, or behavioral migraine management +β-blocker. Daily diaries assessed migraine activity for the 16 months of the trial. The Migraine Specific Quality of Life Questionnaire and Headache Disability Inventory assessed headache-related disability at regular intervals. Mixed models for repeated measures examined changes in these three outcomes with preventative migraine therapy in participants with and without a mood or anxiety disorder diagnosis.
Participants with a comorbid mood or anxiety disorder diagnosis recorded larger reductions in migraine days (p < .05) and larger reductions in the Migraine Specific Quality of Life Questionnaire (p < .001) and Headache Disability Inventory (p < .01) than did participants with neither diagnosis.
Significantly larger reductions in migraine activity and migraine-related disability were observed in participants with a mood and/or anxiety disorder diagnosis than in participants who did not receive either diagnosis.
情绪和焦虑障碍与偏头痛共病，并通常被认为预示着预防偏头痛治疗的反应不佳。然而，几乎没有证据支持这种假设。
我们使用美国精神病学协会诊断和统计手册标准，检查了情绪和/或焦虑障碍诊断对治疗严重偏头痛试验中评估的三种预防偏头痛治疗方法（n=177）反应的影响：β受体阻滞剂、行为性偏头痛管理或行为性偏头痛管理+β受体阻滞剂。每日日记评估了试验期间 16 个月的偏头痛活动。偏头痛特异性生活质量问卷和头痛残疾量表定期评估头痛相关残疾。重复测量混合模型检查了有和没有情绪或焦虑障碍诊断的参与者在预防偏头痛治疗中这三个结果的变化。
伴有共病情绪或焦虑障碍诊断的参与者记录的偏头痛天数减少更大（p<.05），偏头痛特异性生活质量问卷（p<.001）和头痛残疾量表（p<.01）的减少也更大。
与未接受任何诊断的参与者相比，伴有情绪和/或焦虑障碍诊断的参与者的偏头痛活动和偏头痛相关残疾显著减少更大。
