Department of Neurology and Neurosurgery, Federal University of São Paulo, Botucatu Street 720, São Paulo, 04023-900, Brazil.
Acta Neurol Belg. 2013 Mar;113(1):61-5. doi: 10.1007/s13760-012-0135-9. Epub 2012 Oct 2.
Psychiatric comorbidity in patients with headache contributes to poorer prognosis, chronification of disease, poor response to treatment, increased cost of treatment, and decreased quality of life. The purpose of the present study was to evaluate the depressive symptoms in adolescents with chronic and episodic migraines and healthy adolescents. The study was performed between November 2010 and November 2011. All patients completed a detailed headache questionnaire comprising of demographical and clinical data and were instructed to fill out a headache diary over a 2-month period. The subjects ranged in age from 13 to 19 years. To evaluate depression symptoms, all of the subjects were asked to fill out the Beck Depression Inventory (BDI). A total of 137 participants were evaluated; 44 had episodic migraine (EM), 46 had chronic migraine (CM) and 47 were control subjects. Patients with a history of chronic migraine had significantly higher scores on the BDI than the other participants. Patients with chronic migraine had BDI scores that were 8.8 points higher than controls [95 % CI (β) = 5.0, 12.6] and 5.8 points higher than patients with EM [95 % CI (β) = 2.2, 9.4]. The main finding of this study was that chronic migraine is strongly associated with depression symptoms, regardless of demographic data. Comorbid depression may increase the total burden of migraine and diagnosis and treatment of depression in adolescents with migraine is likely to result in a better prognosis.
头痛患者的精神共病会导致预后较差、疾病慢性化、治疗反应不佳、治疗费用增加和生活质量下降。本研究的目的是评估慢性和发作性偏头痛青少年与健康青少年的抑郁症状。该研究于 2010 年 11 月至 2011 年 11 月进行。所有患者均完成了详细的头痛问卷,包括人口统计学和临床数据,并被指示在 2 个月内填写头痛日记。受试者年龄在 13 至 19 岁之间。为了评估抑郁症状,所有受试者都被要求填写贝克抑郁量表 (BDI)。共有 137 名参与者接受了评估;44 名患有发作性偏头痛 (EM),46 名患有慢性偏头痛 (CM),47 名为对照组。有慢性偏头痛病史的患者 BDI 评分明显高于其他参与者。慢性偏头痛患者的 BDI 评分比对照组高 8.8 分[95%置信区间 (β)=5.0,12.6],比 EM 患者高 5.8 分[95%置信区间 (β)=2.2,9.4]。这项研究的主要发现是,无论人口统计学数据如何,慢性偏头痛与抑郁症状密切相关。共病性抑郁可能会增加偏头痛的总负担,对偏头痛青少年进行抑郁诊断和治疗可能会带来更好的预后。