Rammohan K, Mundayadan Shyma Manikkoth, Das Soumitra, Shaji C Velayudhan
Department of Neurology, TD MCH, Alappuzha, Kerala, India.
Department of Neurology, PVS Memorial Hospital, Kochi, Kerala, India.
J Neurosci Rural Pract. 2019 Jan-Mar;10(1):28-33. doi: 10.4103/jnrp.jnrp_146_18.
Both migraine and mood disorders are prevalent disorders with many studies demonstrating that they are comorbid with each other with increased migraine-related disability in such patients.
The aim of the study is to test the hypothesis that mood disorders are comorbid with migraine with increased disability and to identify any clinical features in migraineurs which may be associated with mood disorders.
Patients presenting with complaints of headache to the Neurology Outpatient Department of a Tertiary CARE Hospital from August 01, 2016 to February 28, 2017, were subjected to International Classification of Headache Disorder 3 beta criteria to satisfy a diagnosis of migraine and were assessed in detail as to headache characteristics. Mood disorders were assessed by Hospital Anxiety and Depression Scale and migraine-related disability was assessed by Migraine Disability Assessment Questionnaire. Patients with serious medical complaints, known previous psychiatric disease, other types of headaches and recent prophylactic drug intake were carefully excluded.
A total of 133 patients were studied. The duration and frequency of migraine headaches were found to correlate with the presence of mood disorders and the migraine-related disability in patients with comorbid mood disorders was significantly higher. Factors such as total duration of migraine, aura, vomiting, phono, and photophobia were not found to be statistically correlated with mood disorders.
Rates of depression and anxiety in migraine vary widely in various studies due to variations in study criteria, population characteristics and various scales used. We found a prevalence of 16.54% of anxiety and 9.02% of depression in migraineurs, a rate comparable to or less than many studies in international literature and a significantly increased disability in individuals with comorbid mood disorders and migraine. Routinely including questionnaires such as HAD in screening patients with migraine to rule out comorbid mood disorders may be warranted. Because we have carefully excluded all other primary (especially tension and medication overuse headaches) and secondary headaches and selected prophylactic drug naïve patients, we contend that this study provides a clear clinical profile of migraineurs with mood disorders.
偏头痛和情绪障碍都是常见疾病，许多研究表明它们彼此共病，此类患者中与偏头痛相关的残疾有所增加。
本研究的目的是检验情绪障碍与偏头痛共病且残疾增加这一假设，并确定偏头痛患者中可能与情绪障碍相关的任何临床特征。
2016年8月1日至2017年2月28日期间，在一家三级医疗医院神经内科门诊因头痛主诉就诊的患者，按照《国际头痛疾病分类第3版β标准》进行诊断以确诊偏头痛，并对头痛特征进行详细评估。通过医院焦虑抑郁量表评估情绪障碍，通过偏头痛残疾评估问卷评估与偏头痛相关的残疾。仔细排除有严重内科疾病、既往已知精神疾病、其他类型头痛以及近期服用预防性药物的患者。
共研究了133例患者。发现偏头痛头痛的持续时间和频率与情绪障碍的存在相关，共病情绪障碍患者中与偏头痛相关的残疾显著更高。偏头痛的总持续时间、先兆、呕吐、畏声和畏光等因素与情绪障碍无统计学相关性。
由于研究标准、人群特征和所使用的各种量表不同，不同研究中偏头痛患者的抑郁和焦虑发生率差异很大。我们发现偏头痛患者中焦虑患病率为16.54%，抑郁患病率为9.02%，这一比例与国际文献中的许多研究相当或更低，且共病情绪障碍和偏头痛的个体残疾显著增加。在筛查偏头痛患者以排除共病情绪障碍时，常规纳入医院焦虑抑郁量表等问卷可能是必要的。由于我们仔细排除了所有其他原发性（尤其是紧张性头痛和药物过量使用性头痛）和继发性头痛，并选择了未服用预防性药物的患者，我们认为本研究提供了偏头痛伴情绪障碍患者清晰的临床概况。
