巴西 ELSA 研究中的偏头痛和心境/焦虑障碍。

Migraine headaches and mood/anxiety disorders in the ELSA Brazil.

机构信息

Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.

出版信息

Headache. 2014 Sep;54(8):1310-9. doi: 10.1111/head.12397. Epub 2014 Jun 4.

DOI:10.1111/head.12397

PMID:24898830

Abstract

OBJECTIVE

To describe the relationship between mood/anxiety disorders and migraine headaches emphasizing the frequency of episodes based in a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health.

BACKGROUND

It has been suggested that frequency of migraine headaches can be directly associated with the presence of psychiatric disorders.

METHODS

Migraine headaches (International Headache Society criteria) was classified as <1×/month, 1×/month-1×/week, 2-6×/week, and daily. Psychiatric disorders using the Clinical Interview Schedule - Revised were classified in 6 categories: common mental (CMD), major depressive (MDD), generalized anxiety (GAD), panic, obsessive-compulsive (OCD), and mixed anxiety and depressive (MADD) disorders. We performed multivariate logistic models adjusted for age, race, education, marital status, income, and use of selective serotonin reuptake inhibitors.

RESULTS

In our sample, 1261 presented definite migraine and 10,531 without migraine headaches (reference). Our main result was an increase in the strength of association between migraine and MDD as frequency of migraine increased for all sample: odds ratio of 2.14 (95% confidence interval [CI] 1.33-3.43) for <1 episode of migraine/month to 6.94 (95% CI 4.20-11.49) for daily headaches for all sample. Significant associations with migraine were also found for GAD, OCD, MADD, and CMD for total sample: MDD, GAD, OCD, MADD, and CMD for women, and MADD and CMD for men. Among men with daily migraine complaint, we found a significant association between migraine and OCD after correction for multiple comparisons (odds ratio 29.86 [95% CI 4.66-191.43]). Analyzing probable and definite migraine cases together, we replicated the findings in a lower magnitude.

CONCLUSIONS

The increase in migraine frequency was associated with progressively higher frequencies of having mood/anxiety disorders in all samples suggesting for some psychiatric disorders a likely dose-response effect especially for women.

摘要

目的

描述心境/焦虑障碍与偏头痛之间的关系，重点强调基于横断面分析的发作频率，该分析来自巴西成人健康纵向研究。

背景

有研究表明，偏头痛发作频率可能与精神疾病的存在直接相关。

方法

根据国际头痛协会标准，偏头痛（International Headache Society criteria）分为<1 次/月、1-1 次/周、2-6 次/周和每日。使用临床访谈时间表修订版（Clinical Interview Schedule - Revised）将精神疾病分为 6 类：常见精神障碍（CMD）、重度抑郁（MDD）、广泛性焦虑（GAD）、惊恐障碍、强迫症（OCD）和混合焦虑和抑郁（MADD）障碍。我们进行了多变量逻辑回归模型调整，调整因素包括年龄、种族、教育程度、婚姻状况、收入和选择性 5-羟色胺再摄取抑制剂的使用。

结果

在我们的样本中，1261 人患有明确的偏头痛，10531 人没有偏头痛（对照）。我们的主要结果是，随着偏头痛发作频率的增加，偏头痛与 MDD 之间的关联强度增加，对于所有样本：偏头痛每月发作<1 次的比值比为 2.14（95%置信区间 [CI] 1.33-3.43），每日头痛的比值比为 6.94（95% CI 4.20-11.49）。对于所有样本，与偏头痛相关的还有 GAD、OCD、MADD 和 CMD：女性的 MDD、GAD、OCD、MADD 和 CMD，男性的 MADD 和 CMD。在每日偏头痛抱怨的男性中，我们发现经过多次比较校正后，偏头痛与 OCD 之间存在显著关联（比值比 29.86 [95% CI 4.66-191.43]）。同时分析可能和明确的偏头痛病例，我们在更低的程度上复制了这些发现。