Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, MA 02215, USA.
Cephalalgia. 2013 Sep;33(12):1017-25. doi: 10.1177/0333102413483930. Epub 2013 Apr 15.
While cross-sectional studies have shown associations between migraine and depression, few studies have been able to evaluate the association between migraine and incident depression.
A prospective cohort study among 36,016 women without a history of depression enrolled in the Women's Health Study who provided information about migraine and headache at baseline. Women were classified as either having nonmigraine headache, migraine with aura, migraine without aura, past history of migraine or no history of headache. Cox proportional hazards models were used to evaluate the association between migraine and headache status and incident depression.
At baseline, 5115 women reported a history of nonmigraine headache, 1805 reported migraine with aura, 2723 reported migraine without aura, and 1896 reported a past history of migraine. During 13.8 mean years of follow-up, 3833 new cases of depression occurred. The adjusted relative risks of incident depression were 1.44 (95% CI: 1.32, 1.56) for nonmigraine headache, 1.53 (95% CI: 1.35, 1.74) for migraine with aura, 1.40 (95% CI: 1.25, 1.56) for migraine without aura, and 1.56 (95% CI: 1.37, 1.77) for past history of migraine compared to no history of headache.
Middle-aged women with migraine or nonmigraine headache are at increased risk of incident depression. Frequent migraine attacks (weekly or daily) were associated with the highest risk for developing depression.
尽管横断面研究表明偏头痛与抑郁之间存在关联,但很少有研究能够评估偏头痛与新发抑郁之间的关联。
这是一项在妇女健康研究中进行的前瞻性队列研究,共纳入 36016 名无抑郁病史的女性,她们在基线时提供了偏头痛和头痛的相关信息。女性被分为无偏头痛性头痛、有先兆偏头痛、无先兆偏头痛、偏头痛病史或无头痛史。采用 Cox 比例风险模型评估偏头痛和头痛状况与新发抑郁之间的关联。
基线时,5115 名女性报告有非偏头痛性头痛史,1805 名女性报告有先兆偏头痛,2723 名女性报告有无先兆偏头痛,1896 名女性报告有偏头痛病史。在 13.8 年的平均随访期间,有 3833 例新发抑郁症。调整后的新发抑郁相对风险分别为:无偏头痛性头痛为 1.44(95%CI:1.32,1.56)、有先兆偏头痛为 1.53(95%CI:1.35,1.74)、无先兆偏头痛为 1.40(95%CI:1.25,1.56)、偏头痛病史为 1.56(95%CI:1.37,1.77),与无头痛史相比。
中年女性偏头痛或无偏头痛性头痛患者新发抑郁的风险增加。频繁的偏头痛发作(每周或每天)与发生抑郁的风险最高相关。