Comorbidity of migraine and depression - Investigating potential etiology and prognosis
Comorbidity of migraine and depression - Investigating potential etiology and prognosis
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DOI：
10.1212/01.wnl.0000058907.41080.54
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发表时间：
2003-04-22
期刊：
影响因子：
9.9
通讯作者：
Welch, KMA
中科院分区：
文献类型：
--
作者：
Breslau, N;Lipton, RB;Welch, KMA
背景：在临床和社区样本中已经观察到偏头痛和重性抑郁症之间的关联。促成这种关联的因素及其影响尚不清楚。目的：探讨偏头痛与抑郁症的相关因素。研究方法：1997年首次对年龄在25 ~ 55岁之间的偏头痛患者（n = 496）或其他严重程度相当的头痛患者（n = 151）以及从普通社区随机选择的无严重头痛病史的对照组（n = 539）进行了队列研究，并于1999年再次进行了访谈。结果如下：基线时的重度抑郁症可预测2年随访期间的首次发作偏头痛（比值比[OR] = 3.4; 95% CI = 1.4，8.7），但不能预测其他严重头痛（OR = 0.6; 95% CI = 0.1，4.6）。基线偏头痛可预测随访期间首次发作的重性抑郁症（OR = 5.8; 95%CI = 2.7，12.3）;重度头痛与重性抑郁症的前瞻性关联不显著（OR = 2.7; 95%CI = 0.9，8.1）。共病抑郁症并不影响偏头痛发作的频率、持续性或偏头痛相关残疾随时间的进展。结论：重度抑郁症增加了偏头痛的风险，而偏头痛增加了重度抑郁症的风险。这种双向关联，即每种疾病都会增加另一种疾病首次发作的风险，但在与其他严重头痛的关系中没有观察到。关于其他严重头痛，与先前存在的重度抑郁症相关的风险没有增加，尽管有可能产生相反的影响（即，从严重的头痛到抑郁症）都不能被可靠地排除。
Background: An association between migraine and major depression has been observed in clinical and community samples. The factors that contribute to this association and their implications remain unclear. Objective: To determine the factors contributing to the association of migraine and major depression. Methods: A cohort study of persons aged 25 to 55 years with migraine (n = 496) or with other headaches of comparable severity (n = 151) and control subjects with no history of severe headaches (n = 539) randomly selected from the general community were interviewed first in 1997 and then reinterviewed in 1999. Results: Major depression at baseline predicted the first-onset migraine during the 2-year follow-up period (odds ratio [OR] = 3.4; 95% Cl = 1.4, 8.7) but not other severe headaches (OR = 0.6; 95% CI = 0.1, 4.6). Migraine at baseline predicted the first-onset major depression during follow-up (OR = 5.8; 95% CI = 2.7, 12.3); the prospective association from severe headaches to major depression was not significant (OR = 2.7; 95% CI = 0.9, 8.1). Comorbid major depression did not influence the frequency of migraine attacks, their persistence, or the progression of migraine-related disability over time. Conclusions: Major depression increased the risk for migraine, and migraine increased the risk for major depression. This bidirectional association, with each disorder increasing the risk for first onset of the other, was not observed in relation to other severe headaches. With respect to other severe headaches, there was no increased risk associated with pre-existing major depression, although the possibility of an influence in the reverse direction (i.e., from severe headaches to depression) cannot be securely ruled out.