Hung Ching-I, Liu Chia-Yih, Yang Ching-Hui, Wang Shuu-Jiun
Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung University School of Medicine, Tao-Yuan, Taiwan.
Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.
PLoS One. 2015 May 22;10(5):e0128087. doi: 10.1371/journal.pone.0128087. eCollection 2015.
No study has investigated the impacts of migraine on depression, anxiety, and somatic symptoms and remission at the two-year follow-up point among patients with major depressive disorder (MDD). This study aimed to investigate the above issues.
Psychiatric outpatients with MDD recruited at baseline were investigated at a two-year follow-up (N = 106). The Hamilton Depression Rating Scale, Hospital Anxiety and Depression Scale, and Depression and Somatic Symptoms Scale were used. Migraine was diagnosed according to the International Classification of Headache Disorders, 2nd edition. The patients were divided into no migraine, inactive migraine, and active migraine subgroups. Multiple logistic regressions were used to investigate the significant factors related to full remission of depression.
Among patients without pharmacotherapy at the follow-up, patients with active migraine had significantly greater severities of anxiety and somatic symptoms as compared with patients without migraine; moreover, patients with active migraine had the lowest improvement percentage and full remission rate. There were no significant differences in depression, anxiety, and somatic symptoms between patients with inactive migraine and those without migraine. Active headache at follow-up was a significant factor related to a lower full remission rate.
Active headache at follow-up was associated with a lower rate of full remission and more residual anxiety and somatic symptoms at follow-up among patients with migraine. Physicians should integrate a treatment plan for depression and migraine for the treatment of patients with MDD.
尚无研究调查偏头痛对重度抑郁症(MDD)患者在两年随访期内的抑郁、焦虑、躯体症状及症状缓解情况的影响。本研究旨在调查上述问题。
对基线时招募的患有MDD的精神科门诊患者进行了为期两年的随访(N = 106)。使用了汉密尔顿抑郁量表、医院焦虑抑郁量表和抑郁与躯体症状量表。偏头痛根据《国际头痛疾病分类》第2版进行诊断。患者被分为无偏头痛、静止性偏头痛和活动性偏头痛亚组。采用多元逻辑回归分析来研究与抑郁症完全缓解相关的显著因素。
在随访时未接受药物治疗的患者中,活动性偏头痛患者的焦虑和躯体症状严重程度显著高于无偏头痛患者;此外,活动性偏头痛患者的改善率和完全缓解率最低。静止性偏头痛患者与无偏头痛患者在抑郁、焦虑和躯体症状方面无显著差异。随访时的活动性头痛是与完全缓解率较低相关的一个显著因素。
随访时的活动性头痛与偏头痛患者随访时较低的完全缓解率以及更多的残留焦虑和躯体症状相关。医生应为MDD患者制定抑郁症和偏头痛的综合治疗方案。