A Population-Based Longitudinal Community Study of Major Depression and Migraine

Authors

  • Geeta Modgill MSc,

    Corresponding author
    1. From Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, and S.B. Patten); Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (N. Jette and W.J. Becker); Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (J.L. Wang and S.B. Patten); Hotchkiss Brain Institute, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, W.J. Becker, and S.B. Patten).
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  • Nathalie Jette MD, MSc,

    1. From Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, and S.B. Patten); Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (N. Jette and W.J. Becker); Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (J.L. Wang and S.B. Patten); Hotchkiss Brain Institute, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, W.J. Becker, and S.B. Patten).
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  • Jian Li Wang PhD,

    1. From Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, and S.B. Patten); Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (N. Jette and W.J. Becker); Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (J.L. Wang and S.B. Patten); Hotchkiss Brain Institute, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, W.J. Becker, and S.B. Patten).
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  • Werner J. Becker MD,

    1. From Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, and S.B. Patten); Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (N. Jette and W.J. Becker); Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (J.L. Wang and S.B. Patten); Hotchkiss Brain Institute, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, W.J. Becker, and S.B. Patten).
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  • Scott B. Patten MD, PhD

    1. From Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, and S.B. Patten); Department of Clinical Neurosciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (N. Jette and W.J. Becker); Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada (J.L. Wang and S.B. Patten); Hotchkiss Brain Institute, Calgary, AB, Canada (G. Modgill, N. Jette, J.L. Wang, W.J. Becker, and S.B. Patten).
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  • Conflict of Interest: None of the authors have relevant conflicts of interest to report.

  • Sources of financial support: Drs. Patten and Jette are supported by Alberta Innovates, Health Solutions. Dr. Jette holds a Canada Research Tier 2 in Neurological Population Health and Health Services Research. Dr. Wang holds a New Investigator Award from the Canadian Institutes of Health Research. This work was supported by a grant from the Canadian Institutes of Health Research.

  • While the research and analysis presented in this article are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada.

G. Modgill, Community Health Sciences, University of Calgary, 3rd Floor TRW, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6, email: modgillg@ucalgary.ca

Abstract

Objective.— To examine whether major depressive episodes (MDEs) are associated with an increased risk of migraine in the general population and to examine whether migraine is associated with an increase risk of MDE.

Background.— Population-based cross-sectional studies have consistently reported an association between migraine and depression. However, longitudinal studies about this potentially bidirectional association are inconsistent.

Methods.— This retrospective cohort study used 12 years of follow-up data from the Canadian National Population Health Survey (15,254 respondents, age >12). Stratified analysis, logistic regression, and proportional hazard modeling were used to quantify the effect of migraine on subsequent MDE status and vice versa.

Results.— After adjusting for sex, age, and other chronic health conditions, respondents with migraine were 60% more likely (HR 1.6, 95% confidence interval 1.3-1.9) to develop MDE compared with those without migraine. Similarly adjusting for sex and age, respondents with MDE were 40% more likely (HR 1.4, 95% confidence interval 1.0-1.9) to develop migraine compared with those without MDE. However, the latter association disappeared after adjustment for stress and childhood trauma.

Conclusions.— The current study provides substantial evidence that migraine is associated with the later development of MDEs, but does not provide strong causal evidence of an association in the other direction. Environmental factors such as childhood trauma and stress may shape the expression of this bidirectional relationship; however, the precise underlying mechanisms are not yet known.

(Headache 2012;52:422-432)

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