Translational Brain Science, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Health Data Research UK, Birmingham, UK.
Headache. 2023 Feb;63(2):290-298. doi: 10.1111/head.14465. Epub 2023 Feb 7.
To evaluate mental health burden in women with idiopathic intracranial hypertension (IIH) compared to matched women with migraine and population controls.
Depression and anxiety are recognized comorbid conditions in those with IIH and lead to worse predicted medical outcomes. The mental health burden in IIH has not been previously evaluated in a large, matched cohort study.
We performed a population-based matched, retrospective cohort study to explore mental health outcomes (depression and anxiety). We used data from IQVIA Medical Research Data, an anonymized, nationally representative primary care electronic medical records database in the United Kingdom, from January 1, 1995, to September 25, 2019. Women aged ≥16 years were eligible for inclusion. Women with IIH (exposure) were matched by age and body mass index with up to 10 control women without IIH but with migraine (migraine controls), and without IIH or migraine (population controls).
A total of 3411 women with IIH, 30,879 migraine controls and 33,495 population controls were included. Of these, 237, 2372 and 1695 women with IIH, migraine controls and population controls, respectively, developed depression during follow-up, and 179, 1826 and 1197, respectively, developed anxiety. There was a greater hazard of depression and anxiety in IIH compared to population controls (adjusted hazard ratio [aHR] 1.38, 95% confidence interval [CI] 1.20-1.58; and aHR 1.40, 95% CI 1.19-1.64, respectively), while hazards were similar to migraine controls (aHR 0.98, 95% CI 0.86-1.13; and aHR 0.98, 95% CI 0.83-1.14, respectively).
Depression and anxiety burden in women with IIH is higher than in the general population, and comparable to that in matched women with migraine. This may indicate that presence of headache is a potential driver for comorbid depression and anxiety in IIH.
评估特发性颅内高压（IIH）女性患者与匹配的偏头痛女性患者和普通人群对照者相比，心理健康负担情况。
抑郁和焦虑是 IIH 患者的公认合并症，并导致预测的医疗结果更差。IIH 患者的心理健康负担尚未在大规模匹配队列研究中进行评估。
我们进行了一项基于人群的匹配、回顾性队列研究，以探索心理健康结局（抑郁和焦虑）。我们使用了来自 IQVIA Medical Research Data 的数据，这是一个来自英国的匿名、全国代表性的初级保健电子病历数据库，数据时间范围为 1995 年 1 月 1 日至 2019 年 9 月 25 日。年龄≥16 岁的女性有资格入组。患有 IIH（暴露）的女性与多达 10 名无 IIH 但患有偏头痛的女性（偏头痛对照组）和无 IIH 或偏头痛的女性（普通人群对照组）按年龄和体重指数匹配。
共纳入 3411 名 IIH 女性、30879 名偏头痛对照组女性和 33495 名普通人群对照组女性。在这些女性中，分别有 237、2372 和 1695 名 IIH、偏头痛对照组和普通人群对照组女性在随访期间发生抑郁，分别有 179、1826 和 1197 名 IIH、偏头痛对照组和普通人群对照组女性发生焦虑。与普通人群对照组相比，IIH 患者发生抑郁和焦虑的风险更高（调整后的危险比 [aHR] 1.38，95%置信区间 [CI] 1.20-1.58；和 aHR 1.40，95% CI 1.19-1.64），而与偏头痛对照组的风险相似（aHR 0.98，95% CI 0.86-1.13；和 aHR 0.98，95% CI 0.83-1.14）。
IIH 女性的抑郁和焦虑负担高于普通人群，与匹配的偏头痛女性相当。这可能表明头痛的存在是 IIH 中合并抑郁和焦虑的潜在驱动因素。
