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The Impact of Migraine on Patients With Major Depressive Disorder


  • Ching-I Hung MD,

  • Chia-Yih Liu MD,

  • Yeong-Yuh Juang MD,

  • Shuu-Jiun Wang MD

  • From the Neurological Institute, Taipei Veterans General Hospital and Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan (Dr. Wang); and Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University School of Medicine, Taoyuan, Taiwan (Drs. Hung, Liu, and Juang).

Address all correspondence to Dr. Shuu-Jiun Wang, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.


Background.—The impact of migraine and other headache types among psychiatric outpatients with major depressive disorder (MDD) has not been fully described.

Objective.—To investigate the impact of migraine on the severity, physical, and anxiety symptoms in patients with MDD and to examine the interaction between headache and depression.

Methods.—This clinic-based study enrolled consecutive psychiatric outpatients meeting DSM-IV criteria for MDD. Headache types were diagnosed based on the International Classification of Headache Disorders, 2nd edition (2004). Three psychometric instruments were used to evaluate anxiety, depression, and physical components: the Hamilton Depression Rating Scale, the Beck Depression Inventory, and the Hospital Anxiety and Depression Scale. In addition, the interactions between headache and their depressive episode were also evaluated.

Results.—Compared with patients without migraine, MDD patients with comorbid migraine (n = 73, 48.3%) had higher physical and anxiety scores on the three psychometric instruments. Migraine accounted for 5% to 11% of the variance of the total scores on the three psychometric scales. Approximately half (48.5%) of patients reported headache worsening during or after a depressive episode.

Conclusions.—Our study found that comorbidity of migraine in patients with MDD was associated with more anxiety and physical symptoms. Headache should not be considered as only a somatic symptom of depression, but should be treated as an important comorbid disorder because it might exacerbate or interact with depression during a depressive episode.

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