Duan Shaojie, Ren Zhiying, Xia Hui, Wang Ziyao, Zheng Tao, Li Guanglu, Liu Lei, Liu Zunjing
Department of Geriatrics, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.
Graduate School of Beijing University of Chinese Medicine, Beijing, China.
Front Neurol. 2023 Apr 25;14:1090878. doi: 10.3389/fneur.2023.1090878. eCollection 2023.
Anxiety and depression are the most common psychiatric comorbidities in migraine, but their impact on the risk of developing migraine and their gender and age differences are unclear, and research on their associations with migraine-related burdens are limited.
To systematically explore the association between anxiety and depression with migraine and migraine-related burdens, including the risk of developing migraine, as well as migraine frequency, severity, disability, headache impact, quality of life and sleep quality.
A total of 170 migraineurs and 85 sex-and age-matched healthy control subjects were recruited consecutively for this study. Anxiety and depression were assessed using Zung's Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS), respectively. Logistic regression and linear regression analyses were used to explore the associations between anxiety and depression with migraine and its burdens. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SAS score and SDS score on migraine and its severe burdens.
After adjusting for confounders, anxiety and depression remained significantly associated with an increased risk of developing migraine, with odds ratios of 5.186 (95% CI:1.755-15.322) and 3.147 (95% CI:1.387-7.141), respectively. Meanwhile, there were significant additive interactions between the association of anxiety and depression with the risk of developing migraine in gender and age ( for interaction <0.05), and the stronger correlations were found in participants with an age ≤ 36 years old and females. In addition, anxiety and depression were significantly independently associated with the migraine frequency, severity, disability, headache impact, quality of life, and sleep quality in migraine patients ( trend <0.05). The area under the ROC curve (AUC) of SAS score in predicting developing migraine was significantly higher than that of SDS score [0.749 (95% CI: 0.691-0.801) vs. 0.633 (95% CI: 0.571-0.692), < 0.0001].
Anxiety and depression were significantly independently associated with the increased risk of migraine and migraine-related burdens. Enhanced assessment of SAS score and SDS score is of great clinical value for the early prevention and treatment of migraine and its burdens.
焦虑和抑郁是偏头痛最常见的精神共病，但它们对偏头痛发病风险的影响以及性别和年龄差异尚不清楚，且关于它们与偏头痛相关负担的关联研究有限。
系统探讨焦虑和抑郁与偏头痛及偏头痛相关负担之间的关联，包括偏头痛的发病风险、偏头痛频率、严重程度、残疾程度、头痛影响、生活质量和睡眠质量。
本研究连续招募了170名偏头痛患者和85名性别及年龄匹配的健康对照者。分别使用zung自评焦虑量表（SAS）和自评抑郁量表（SDS）评估焦虑和抑郁情况。采用逻辑回归和线性回归分析探讨焦虑和抑郁与偏头痛及其负担之间的关联。采用受试者工作特征（ROC）曲线评估SAS评分和SDS评分对偏头痛及其严重负担的预测价值。
在调整混杂因素后，焦虑和抑郁仍与偏头痛发病风险增加显著相关，优势比分别为5.186（95%CI：1.755 - 15.322）和3.147（95%CI：1.387 - 7.141）。同时，焦虑和抑郁与偏头痛发病风险的关联在性别和年龄方面存在显著的相加交互作用（交互作用P<0.05），在年龄≤36岁的参与者和女性中相关性更强。此外，焦虑和抑郁与偏头痛患者的偏头痛频率、严重程度、残疾程度、头痛影响、生活质量和睡眠质量显著独立相关（趋势P<0.05）。SAS评分预测偏头痛发病的ROC曲线下面积（AUC）显著高于SDS评分[0.749（95%CI：0.691 - 0.801）对0.633（95%CI：0.571 - 0.692），P<0.0001]。
焦虑和抑郁与偏头痛风险增加及偏头痛相关负担显著独立相关。加强对SAS评分和SDS评分的评估对偏头痛及其负担的早期预防和治疗具有重要临床价值。
