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Comorbidity of migraine and depression: Investigating potential etiology and prognosis
Abstract
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% CI = 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.
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“In the general population, depression is associated with a wide range of health, mental health, and neurological conditions, such as 1) chronic pain [71–75]; 2) headaches and migraines [76–79]; 3) diabetes [80–82]; 4) low testosterone [83–85]; 5) cardiovascular, cerebrovascular, and small vessel ischemic disease [86–92]; 6) PD [93]; 7) MCI [94–96]; and 8) AD [97].”
From The Need to Separate Chronic Traumatic Encephalopathy Neuropathology from Clinical Features (2017) · cites this paper as [78]
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Migraine, depression, and brain volume
Gudmundsson, L. S., Scher, I., Sigurdsson, S. O., Geerlings, M. I., Vidal, J., Eiríksdóttir, G., Garcia, M., Harris, T. B., Kjartansson, Ó., Aspelund, T., et al. (2013) · Neurology · doi:10.1212/wnl.0b013e318295d69e · Cited by 44
Seng, E. K., & Holroyd, K. A. (2012) · Cephalalgia · doi:10.1177/0333102411436333 · Cited by 44
Associations Between Migraine and the Most Common Psychiatric Co‐Morbidities
Bergman‐Bock, S. (2017) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13146 · Cited by 44
Understanding migraine and psychiatric comorbidity
Seng, E. K., & Seng, C. D. (2016) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000309 · Cited by 44
Affatato, O., Moulin, T. C., Pisanu, C., Babasieva, V. S., Russo, M., Aydınlar, E. I., Torelli, P., Chubarev, V. N., Tarasov, V. V., Schiöth, H. B., et al. (2021) · Journal of Translational Medicine · doi:10.1186/s12967-021-02801-w · Cited by 43
Association of headache with childhood adversity and mental disorder: cross-national study
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Mitochondrial Energy Depletion in Depression with Somatization
Gardner, A., & Boles, R. G. (2008) · Psychotherapy and Psychosomatics · doi:10.1159/000112891 · Cited by 44
Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia
Llop, S. M., Frandsen, J. E., Digre, K. B., Katz, B. J., Crum, A. V., Zhang, C., & Warner, J. E. A. (2016) · The Journal of Headache and Pain · doi:10.1186/s10194-016-0629-6 · Cited by 43
Depression and disability in migraine: the role of pain acceptance and values-based action
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Traditional and Alternative Treatments for Depression: Implications for Migraine Management
Peck, K. R., Smitherman, T. A., & Baskin, S. M. (2015) · Headache The Journal of Head and Face Pain · doi:10.1111/head.12521 · Cited by 42
Alwhaibi, M., & Alhawassi, T. M. (2020) · Depression and Anxiety · doi:10.1002/da.23063 · Cited by 42
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Migraine: A missing link between somatic symptoms and major depressive disorder
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Allodynia is associated with a higher prevalence of depression in migraine patients
Louter, M., Wardenaar, K. J., Veen, G., van Oosterhout, W., Zitman, F., Ferrari, M. D., & Terwindt, G. (2014) · Cephalalgia · doi:10.1177/0333102414532554 · Cited by 41
Hammond, N. G., Orr, S. L., & Colman, I. (2019) · Headache The Journal of Head and Face Pain · doi:10.1111/head.13644 · Cited by 41
Metadata
- Authors
- Breslau, N., Lipton, R. B., Stewart, W. F., Schultz, L. R., & Welch, K. M. A.
- Affiliations
- Albert Einstein College of Medicine (US)
- Venue
- Neurology
- Published
- 2003-04-22
- Volume
- 60
- Issue
- 8
- Pages
- 1308-1312
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2036344281
- Cited by
- 640
- References
- 25
- Citations by year
- 2026: 21 · 2025: 22 · 2024: 18 · 2023: 18 · 2022: 20 · 2021: 31 · 2020: 27 · 2019: 26 · 2018: 30 · 2017: 15 · 2016: 36 · 2015: 34 · 2014: 30 · 2013: 36 · 2012: 46
- FWCI
- 11.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p50ns032399-05)
- National Institute of Neurological Disorders and Stroke (P50-NS32399)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Migraine and Headache Studies
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Dentistry › Oral Surgery › Temporomandibular Joint Disorders
- Keywords
- migraine, major depressive disorder, comorbidities, bidirectional relationship, severe headache, migraine disability, migraine frequency
- MeSH terms
- Adult, Depression, Major Depressive Disorder, Disease Susceptibility, Female, Follow-Up Studies, Headache, Health Surveys, Humans, Male, Michigan, Middle Aged, Migraine Disorders, Prognosis, Prospective Studies, Risk, Sampling Studies, Cohort Studies, Comorbidity, Incidence, Odds Ratio, Age of Onset
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