Chronic Pain and Depression in the Quality of Life of Women With Migraine - A Controlled Study

• Published in: Headache Vol. 52; no. 3; pp. 400 - 408
• Main Authors: Stuginski-Barbosa, Juliana, Dach, Fabíola, Bigal, Marcelo, Speciali, José G.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.03.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Age; Aged; Analysis of Variance; Biological and medical sciences; Cardiovascular system; Case-Control Studies; Chi-Square Distribution; Chronic Disease; chronic migraine; Demography; Depression; Depression - etiology; Depression - psychology; Female; Headache; Headaches; Humans; Inventories; Inventory; Joints; Medical sciences; Mental depression; Middle Aged; Migraine; Migraine Disorders - complications; Migraine Disorders - psychology; Multivariate analysis; Neurology; Pain; Pain - etiology; Pain - psychology; Pain Measurement; Pharmacology. Drug treatments; Psychiatric Status Rating Scales; Quality of life; Quality of Life - psychology; Retrospective Studies; Standard deviation; Vascular diseases and vascular malformations of the nervous system; Vasodilator agents. Cerebral vasodilators; widespread chronic pain; women's health; Young Adult; Mood disorder; Human; Headache; Nervous system diseases; widespread chronic pain; Migraine; Cardiovascular disease; Depression; Cerebral disorder; Quality of life; Vascular disease; Chronic; Pain; Central nervous system disease; women's health; Neurological disorder; chronic migraine; Cerebrovascular disease
• ISSN: 0017-8748; 1526-4610
• DOI: 10.1111/j.1526-4610.2012.02095.x

Background.— Migraine is comorbid to depression and widespread chronic pain (WCP), but the influence of these conditions on the health‐related quality of life (HRQoL) of individuals with episodic (EM) and chronic migraine (CM) is poorly understood. Objective.— To assess the prevalence of depressive symptoms and WCP in individuals with EM and CM, as well as to estimate the joint impact of these conditions on the HRQoL of these individuals. Methods.— All women aged 18 to 65 years with a first diagnosis of EM or CM from September of 2006 to September of 2008 seen in an outpatient headache service were invited to participate. They were asked to attend a separate appointment in the service, and to bring another woman of similar age that also agreed to participate. Depressive symptoms were assessed using the Beck Depression Inventory. Questions about WCP followed the protocol of the American College of Rheumatology. HRQoL was assessed using the Short‐Form 36 (SF‐36). Multivariate analysis modeled HRQoL as a function of headache status, depressive symptoms, and pain, using quantile regression. Results.— Sample consisted of 179 women, 53 in the EM group, 37 in the CM group and 89 in control group. Groups did not differ by demographics. Mean scores of SF‐36 were 53.6 (standard deviation [SD] = 23.5) for EM, 44.2 (SD = 18.5) for CM and 61.8 (SD = 21.5) for controls. In multivariate analysis, SF‐36 scores were predicted by a CM status (P = .02; −10.05 [95% CI −18.52; −1.58]) and by a Beck Depression Inventory score (P < .01; −1.27 [95% CI −1.55; −0.99]). The influence of WCP in the SF‐36 scores approached significance (P = .08; −0.78 [95% CI −1.64; 0.88]). Age did not contribute to the model. Conclusion.— Women with migraine are at an increased chance of WCP, and the chance increases as a function of headache frequency. Both depressive symptoms and CM independently predict HRQoL status. (Headache 2012;52:400‐408)