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Liou YJ, Chen MH, Hsu JW, Huang KL, Huang PH, Bai YM. Dysfunction of circulating endothelial progenitor cells in major depressive disorder. Acta Neuropsychiatr 2024; 36:153-161. [PMID: 38178721 DOI: 10.1017/neu.2023.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVES Despite mounting evidence demonstrates circulating endothelial progenitor cells (cEPCs) quantitative changes in depression, no study has investigated cEPC functions in major depressive disorder (MDD). We investigated the role of cEPC adhesive and apoptotic functions in MDD. METHODS We recruited 68 patients with MDD and 56 healthy controls (HCs). The depression symptoms, anxiety, psychosomatic symptoms, subjective cognitive dysfunction, quality of life, and functional disability were evaluated using the Hamilton Depression Rating Scale and Montgomery-Åsberg Depression Rating Scale, Hamilton Anxiety Rating Scale, Depression and Somatic Symptoms Scale (DSSS), Perceived Deficits Questionnaire-Depression, 12-Item Short Form Health Survey (SF-12), and Sheehan Disability Scale (SDS), respectively. Working memory and executive function were assessed using a 2-back task and Wisconsin Card Sorting Test (WCST). Inflammatory marker (soluble interleukin-6 receptor, C-reactive protein, and tumor necrosis factor-α receptor-1), cEPC adhesive, and apoptotic levels were measured using in vitro assays. RESULTS The MDD patients showed significantly lower cEPC adhesive levels than the HCs, and this difference in adhesive function remained statistically significant even after adjusting for inflammatory marker levels. The cEPC adhesion levels were in inverse correlations with commission and omission errors in 2-back task, the percent perseverative response and percent perseverative errors in WCST, and the DSSS and SDS scores, but in positive correlations with SF-12 physical and mental component scores. cEPC apoptotic levels did not differ significantly between the groups. CONCLUSION The findings indicate that cEPC adhesive function is diminished in MDD and impacts various aspects of cognitive and psychosocial functions associated with the disorder.
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Affiliation(s)
- Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Price GD, Heinz MV, Song SH, Nemesure MD, Jacobson NC. Using digital phenotyping to capture depression symptom variability: detecting naturalistic variability in depression symptoms across one year using passively collected wearable movement and sleep data. Transl Psychiatry 2023; 13:381. [PMID: 38071317 PMCID: PMC10710399 DOI: 10.1038/s41398-023-02669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Major Depressive Disorder (MDD) presents considerable challenges to diagnosis and management due to symptom variability across time. Only recent work has highlighted the clinical implications for interrogating depression symptom variability. Thus, the present work investigates how sociodemographic, comorbidity, movement, and sleep data is associated with long-term depression symptom variability. Participant information included (N = 939) baseline sociodemographic and comorbidity data, longitudinal, passively collected wearable data, and Patient Health Questionnaire-9 (PHQ-9) scores collected over 12 months. An ensemble machine learning approach was used to detect long-term depression symptom variability via: (i) a domain-driven feature selection approach and (ii) an exhaustive feature-inclusion approach. SHapley Additive exPlanations (SHAP) were used to interrogate variable importance and directionality. The composite domain-driven and exhaustive inclusion models were both capable of moderately detecting long-term depression symptom variability (r = 0.33 and r = 0.39, respectively). Our results indicate the incremental predictive validity of sociodemographic, comorbidity, and passively collected wearable movement and sleep data in detecting long-term depression symptom variability.
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Affiliation(s)
- George D Price
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
- Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH, USA.
| | - Michael V Heinz
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Seo Ho Song
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Matthew D Nemesure
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH, USA
- Digital Data Design Institute, Harvard Business School, Harvard University, Cambridge, MA, USA
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
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Liou YJ, Chen MH, Hsu JW, Huang KL, Huang PH, Bai YM. Circulating endothelial progenitor cell dysfunction in patients with bipolar disorder. Eur Arch Psychiatry Clin Neurosci 2023; 273:1255-1265. [PMID: 36527490 DOI: 10.1007/s00406-022-01530-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
Dysfunction in circulating endothelial progenitor cells (cEPCs) plays a crucial role in cardiovascular disorders (CVDs). Patients with bipolar disorder (BPD) are at increased risk of developing CVDs. This study examined the associations of the functional properties of cEPCs with BPD and its clinical and cognitive characteristics. We recruited 69 patients with BPD and 41 healthy controls (HCs). The levels of manic, depressive, anxiety, psychosomatic symptoms, subjective cognitive dysfunction, quality of life, and functional disability of the BPD group were evaluated using the Young Mania Rating Scale (YMRS), Clinical Global Impression for BPD (CGI-BP), Hamilton Depression Rating Scale, Montgomery-Åsberg Depression Rating Scale, Hamilton Anxiety Rating Scale, Depression and Somatic Symptoms Scale, Perceived Deficits Questionnaire-Depression, 12-Item Short-Form Health Survey, and Sheehan Disability Scale, respectively. Cognitive function was assessed using 2-back and Go/No-Go tasks. Through in vitro assays, the adhesion to fibronectin and the percentage of apoptosis of cEPCs were examined. Under correction for multiple comparisons, the adhesive function of cEPCs in BPD was significantly lower than that in the HCs (corrected P [Pcorr] = 0.027). The reduced adhesive function of cEPCs correlated significantly with increased scores in the YMRS (Pcorr = 0.0002) and the CGI-BP (Pcorr = 0.0009). A lower percentage of apoptotic cEPC cells was associated with greater commission errors in the 2-back (Pcorr = 0.028) and Go/No-Go tasks (Pcorr = 0.029). The cEPCs of the BPD group exhibited attenuated adhesive function. The altered adhesive and apoptotic functions of cEPCs are associated with manic symptom severity and response inhibition deficits in patients with BPD.
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Affiliation(s)
- Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan.
- Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Liou YJ, Chen MH, Hsu JW, Huang KL, Huang PH, Bai YM. Levels of circulating endothelial progenitor cells inversely correlate with manic and positive symptom severity in patients with bipolar disorder. Brain Behav 2022; 12:e2570. [PMID: 35481989 PMCID: PMC9226848 DOI: 10.1002/brb3.2570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/02/2022] [Accepted: 03/19/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Patients with bipolar disorder (BPD) are at high risk of cardiovascular diseases (CVDs) that are attributed to endothelial dysfunction. Circulating endothelial progenitor cells (cEPCs) are proposed as indicators of endothelial dysfunction. This study examined the relationship of cEPC numbers with BPD diagnosis and its clinical symptoms in patients with BPD. METHODS We recruited 48 patients with BPD and 50 healthy controls (HCs). All the patients had scores of <13 on the Young Mania Rating Scale (YMRS). In addition to the YMRS and Clinical Global Impression for BPD (CGI-BP), bipolar patients were assessed using relevant measurements for their depression, anxiety, general psychopathology, cognitive dysfunction and deficit, somatic symptoms, quality of life, and level of disability. cEPC counts were measured using flow cytometry. RESULTS The numbers of immature and mature cEPCs in the bipolar patients did not significantly differ from those in the HCs. After correction for multiple comparisons and controlling for body mass index and smokers, the number of immature cEPCs was observed to be inversely correlated with CGI-BP (corrected p [pcorr ] = .00018) and positive scores in the positive and negative syndrome scale (PANSS-P; pcorr = .0049). The number of mature cEPCs was inversely correlated with YMRS (pcorr = .014), CGI-BP (pcorr = .00022), and PANSS-P (pcorr = .0049) scores. In multivariate stepwise analysis, numbers of both types of cEPCs were associated with CGI-BP. CONCLUSIONS cEPC levels, an indicator of endothelial dysfunction and risk of CVDs, may be associated manic and positive symptom severities in patients with BPD.
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Affiliation(s)
- Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Associations between increased circulating endothelial progenitor cell levels and anxiety/depressive severity, cognitive deficit and function disability among patients with major depressive disorder. Sci Rep 2021; 11:18221. [PMID: 34521977 PMCID: PMC8440504 DOI: 10.1038/s41598-021-97853-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 05/31/2021] [Indexed: 12/11/2022] Open
Abstract
The association of major depressive disorder (MDD) with cardiovascular diseases (CVDs) through endothelial dysfunction is bidirectional. Circulating endothelial progenitor cells (cEPCs), essential for endothelial repair and function, are associated with risks of various CVDs. Here, the relationship of cEPC counts with MDD and the related clinical presentations were investigated in 50 patients with MDD and 46 healthy controls. In patients with MDD, a battery of clinical domains was analysed: depressed mood with Hamilton Depression Rating Scale (HAMD) and Montgomery–Åsberg Depression Rating Scale (MADRS), anxiety with Hamilton Anxiety Rating Scale (HAMA), cognitive dysfunction and deficit with Digit Symbol Substitution Test (DSST) and Perceived Deficits Questionnaire-Depression (PDQ-D), somatic symptoms with Depressive and Somatic Symptom Scale (DSSS), quality of life with 12-Item Short Form Health Survey (SF-12) and functional disability with Sheehan Disability Scale (SDS). Immature and mature cEPC counts were measured through flow cytometry. Increased mature and immature cEPC counts were significantly associated with higher anxiety after controlling the confounding effect of systolic blood pressure, and potentially associated with more severe depressive symptoms, worse cognitive performance and increased cognitive deficit, higher social disability, and worse mental health outcomes. Thus, cEPCs might have pleiotropic effects on MDD-associated symptoms and psychosocial outcomes.
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Lee DH, Kim KM, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Impacts of migraine on the prevalence and clinical presentation of depression: A population-based study. J Affect Disord 2020; 272:215-222. [PMID: 32553361 DOI: 10.1016/j.jad.2020.03.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/29/2020] [Accepted: 03/28/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND A close association has been reported between depression and migraine. However, information concerning the impacts of migraine on the clinical presentation and prevalence of depression in a population-based study is currently limited. METHODS Data from the Korean Headache-Sleep Study, a nationwide survey about headache and sleep for adults aged 19-69 years were used. Depression was defined when Patient Health Questionnaire-9 score ≥ 10. RESULTS Of 2,695 participants who included in this study, 116 (4.3%), 143 (5.3%), and 1130 (41.9%) had depression, migraine, and non-migraine headache, respectively. Migraine (24/116 [20.5%] vs. 119/2579 [4.7%], p < 0.001) and non-migraine headache (67/116 [58.1%] vs. 1063/2579 [41.3%], p < 0.001) was more prevalent in the group of participants with depression than among participants without depression. Among participants with depression, there was no statistically differences in total Patient Health Questionnaire-9 (PHQ-9) scores among migraine, non-migraine headache, and non-headache groups (median with interquartile range, 12.0 [10.2-18.0] vs. 13.0 [11.0-16.0] vs. 12.0 [10.0-15.2], p = 0.514). Among subcomponent scores of PHQ-9, all subcomponent scores did not significantly differ by headache status except feeling tired or having little energy scores (non-migraine headache 2.0 [2.0-3.0] vs. non-headache 2.0 [1.0-2.0], p = 0.010). LIMITATIONS Diagnosis of depression based on PHQ-9 questionnaire and small sample size in subgroup analyses. CONCLUSIONS Participants with depression exhibit an increased risk of migraine and non-migraine headache compared with participants without depression. Among participants with depression, the severity of depression did not significantly differ on the basis of headache status.
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Affiliation(s)
- Dong Hyun Lee
- Department of Neurology, Yeungnam University of College of Medicine, Daegu, Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea
| | - Kwang Ik Yang
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
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Scanlon GC, Jain FA, Hunter AM, Cook IA, Leuchter AF. Neurophysiologic Correlates of Headache Pain in Subjects With Major Depressive Disorder. Clin EEG Neurosci 2017; 48:159-167. [PMID: 27000108 DOI: 10.1177/1550059416632411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Headache pain is often comorbid with major depressive disorder (MDD) and is associated with greater symptom burden, disability, and suicidality. The biological correlates of headache pain in MDD, however, remain obscure. The purpose of this study was to examine the association between brain oscillatory activity and headache pain in MDD subjects. METHODS A total of 64 subjects with MDD who were free of psychoactive medications were evaluated for severity of headache pain in the past week. Brain function was assessed using resting-state quantitative electroencephalography (qEEG). We derived cordance in the theta (4-8 Hz) and alpha (8-12 Hz) frequency bands at each electrode, and examined correlations with headache pain in regions of interest while controlling for depression severity. Frontal and posterior asymmetry in alpha power was calculated in regions of interest. RESULTS Headache pain severity was associated with depression severity ( r = 0.447, P < .001). In bilateral frontal and right posterior regions, alpha cordance was significantly associated with headache intensity, including when controlling for depression severity. The direction of the correlation was positive anteriorly and negative posteriorly. Frontal left dominant alpha asymmetry correlated with severity of headache but not depression symptoms. CONCLUSION Alterations in brain oscillations identified by alpha cordance and alpha asymmetry may be associated with the pathophysiology of headache pain in depression. These findings should be prospectively confirmed.
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Affiliation(s)
- Graham C Scanlon
- 1 UCLA Laboratory of Brain, Behavior, and Pharmacology and the Depression Research and Clinic Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Felipe A Jain
- 1 UCLA Laboratory of Brain, Behavior, and Pharmacology and the Depression Research and Clinic Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Aimee M Hunter
- 1 UCLA Laboratory of Brain, Behavior, and Pharmacology and the Depression Research and Clinic Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Ian A Cook
- 1 UCLA Laboratory of Brain, Behavior, and Pharmacology and the Depression Research and Clinic Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Andrew F Leuchter
- 1 UCLA Laboratory of Brain, Behavior, and Pharmacology and the Depression Research and Clinic Program, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Wei CB, Jia JP, Wang F, Zhou AH, Zuo XM, Chu CB. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study. Chin Med J (Engl) 2017; 129:1394-9. [PMID: 27270532 PMCID: PMC4910360 DOI: 10.4103/0366-6999.183410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Many studies have reported that depression and anxiety have bidirectional relationship with headache. However, few researches investigated the roles of depression or anxiety in patients with headache. We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals. Additional risk factors for depression and anxiety were also analyzed. Methods: A cross-sectional study was conducted at 11 general neurological clinics. All consecutive patients with a chief complaint of headache were enrolled. Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview, and those for headache were made according to the International Classification of Headache Disorders, 2nd Edition. The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity. Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety. Results: A total of 749 outpatients with headache were included. Among them, 148 (19.7%) were diagnosed with depression and 103 (13.7%) with anxiety. Further analysis showed that 114 (15.2%) patients complaining headache due to somatic symptoms of psychiatric disorders and 82 (10.9%) had a depression or anxiety comorbidity with headache. Most patients with depression or anxiety manifested mild to moderate headaches. Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety. Conclusion: Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.
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Affiliation(s)
- Cui-Bai Wei
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050; Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Jian-Ping Jia
- Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050; Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Fen Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Ai-Hong Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xiu-Mei Zuo
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Chang-Biao Chu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Yalinay Dikmen P, Yavuz BG, Aydinlar EI. The relationships between migraine, depression, anxiety, stress, and sleep disturbances. Acta Neurol Belg 2015; 115:117-22. [PMID: 24889393 DOI: 10.1007/s13760-014-0312-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 05/13/2014] [Indexed: 11/24/2022]
Abstract
To assess the relationships between migraine, depression, anxiety, stress, and sleep problems. Psychiatric conditions and sleep disturbances are common in migraineurs. Depression, anxiety, stress, migraine, and sleep problems frequently coexist as comorbidities. Eighty-seven episodic migraineurs (62 females, 25 males; 32.8 ± 6.9) and 41 control subjects (25 females, 16 males; 31.5 ± 5.6) were prospectively enrolled for the study. The participants completed a sociodemographic data form and a migraine disability assessment scale (MIDAS), depression, anxiety, stress scale (DASS), and Pittsburg Sleep Quality Index (PSQI). In migraineurs, a significant positive correlation was found between PSQI total scores and MIDAS scores (migraine related disability for at least three consecutive months) (r = 0. 234, p = 0.04). Only 24.1 % of migraineus (n = 21) had minimal or no disability, 75.9 % of the patients (n = 66) had more than a little disability according to MIDAS scores. PSQI total scores were also correlated with pain intensity over a three month period (MIDAS B) (r = 0.221, p = 0.04). While PSQI scores were found significantly different between migraineurs and control subjects (5.5 ± 2.9 vs 4.5 ± 2.5; p = 0.04), the correlation of all the DASS subscale scores between the groups was not statistically significant. Our findings showed that episodic migraine was a risk factor on its own for sleep disturbances without comorbid depression, anxiety, and stress. Moreover, migraine-related disability and pain intensity in migraine attacks were related to poor sleep quality.
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Affiliation(s)
- Pinar Yalinay Dikmen
- Neurology Department, School of Medicine, Acibadem University, Istanbul, Turkey,
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Migraine genetics: current findings and future lines of research. Neurogenetics 2014; 16:77-95. [PMID: 25501253 DOI: 10.1007/s10048-014-0433-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 11/25/2014] [Indexed: 01/03/2023]
Abstract
In the last two decades, migraine research has greatly advanced our current knowledge of the genetic contributions and the pathophysiology of this common and debilitating disorder. Nonetheless, this knowledge still needs to grow further and to translate into more effective treatments. To date, several genes involved in syndromic and monogenic forms of migraine have been identified, allowing the generation of animal models which have significantly contributed to current knowledge of the mechanisms underlying these rare forms of migraine. Common forms of migraine are instead posing a greater challenge, as they may most often stem from complex interactions between multiple common genetic variants, with environmental triggers. This paper reviews our current understanding of migraine genetics, moving from syndromic and monogenic forms to oligogenic/polygenic migraines most recently addressed with some success through genome-wide association studies. Methodological issues in study design and future perspectives opened by biomarker research will also be briefly addressed.
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Zhu Z, Fan X, Li X, Tan G, Chen L, Zhou J. Prevalence and predictive factors for poor sleep quality among migraineurs in a tertiary hospital headache clinic. Acta Neurol Belg 2013. [PMID: 23180468 DOI: 10.1007/s13760-012-0159-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to investigate the prevalence and predictive factors for poor sleep quality among migraineurs in a tertiary hospital headache clinic in southwest China. In this study, we used a visual analog scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) to assess headache intensity, sleep quality as well as anxiety and depression symptoms. In 211 subjects who were assessed continuously, we found that the average PSQI score was 8.03 ± 4.71, and 130 (61.61 %) migraineurs exhibited poor sleep quality (PSQI >5). Poor sleep quality was largely expressed as experiencing an extended sleep latency period, daytime dysfunction, poor subjective sleep quality, and short sleep duration. The primary factors that predicted poor sleep quality included the migraine history and comorbidity with anxiety and/or depression. Moreover, we found that most migraineurs did not adopt treatment for their poor sleep quality. Only 17 (8.06 %) patients used sleeping medication to improve their poor sleep quality; however, this medication was not effective in 16 (94.12 %) patients. Therefore, it is highly important to resolve poor sleep quality in migraineurs.
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Affiliation(s)
- Zhou Zhu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China
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Hung CI, Liu CY, Wang SJ. Migraine predicts physical and pain symptoms among psychiatric outpatients. J Headache Pain 2013; 14:19. [PMID: 23565902 PMCID: PMC3620433 DOI: 10.1186/1129-2377-14-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 02/19/2013] [Indexed: 11/12/2022] Open
Abstract
Background No study has been performed to compare the impacts of migraine and major depressive episode (MDE) on depression, anxiety and somatic symptoms, and health-related quality of life (HRQoL) among psychiatric outpatients. The aim of this study was to investigate the above issue. Methods This study enrolled consecutive psychiatric outpatients with mood and/or anxiety disorders who undertook a first visit to a medical center. Migraine was diagnosed according to the International Classification of Headache Disorders, 2nd edition. Three psychometric scales and the Short-Form 36 were administered. General linear models were used to estimate the difference in scores contributed by either migraine or MDE. Multiple linear regressions were employed to compare the variance of these scores explained by migraine or MDE. Results Among 214 enrolled participants, 35.0% had migraine. Bipolar II disorder patients (70.0%) had the highest percentage of migraine, followed by major depressive disorder (49.1%) and only anxiety disorder (24.5%). Patients with migraine had worse depression, anxiety, and somatic symptoms and lower SF-36 scores than those without. The estimated differences in the scores of physical functioning, bodily pain, and somatic symptoms contributed by migraine were not lower than those contributed by MDE. The regression model demonstrated the variance explained by migraine was significantly greater than that explained by MDE in physical and pain symptoms. Conclusions Migraine was common and the impact of migraine on physical and pain symptoms was greater than MDE among psychiatric outpatients. Integration of treatment strategies for migraine into psychiatric treatment plans should be considered.
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Affiliation(s)
- Ching-I Hung
- Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang-Gung University School of Medicine, Taoyuan, Taiwan
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13
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Nguyen TV, Low NC. Comorbidity of migraine and mood episodes in a nationally representative population-based sample. Headache 2012; 53:498-506. [PMID: 23095134 DOI: 10.1111/j.1526-4610.2012.02264.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the lifetime comorbidity of migraine with different combinations of mood episodes: (1) manic episodes alone; (2) depressive episodes alone; (3) manic and depressive episodes; (4) controls with no lifetime history of mood episodes, as well as sociodemographic and clinical correlates of migraine for each migraine-mood episode combination. BACKGROUND Migraine has been found to be comorbid with bipolar disorder and major depressive disorder in clinical and population-based samples. However, variability in findings across studies suggests that examining mood episodes separately may be fruitful in determining which of these mood episodes are specifically associated with migraine. METHODS Using a cross-sectional, population-based sample from the Canadian Community Health Survey 1.2 (n = 36,984), sociodemographic and clinical correlates of migraine were examined in each combination of mood episodes as well as controls. Logistic regression analyses controlling for age, sex, and education level compared the lifetime prevalence of migraine (1) between controls and each combination of mood episodes, and then (2) among the different combinations of mood episodes. RESULTS Migraine comorbidity in all combinations of mood episodes was associated with lower socioeconomic status, earlier onset of affective illness, more anxiety, suicidality and use of mental health resources. Compared with controls, the adjusted odds ratio of having migraine was 2.0 (95% confidence interval [CI] 1.4-2.8) for manic episodes alone, 1.9 (95% CI 1.6-2.1) for depressive episodes alone, and 3.0 (95% CI 2.3-3.9) for subjects with both manic and depressive episodes. Compared with those with manic episodes alone and depressive episodes alone, the odds of having migraine were significantly increased in subjects with both manic and depressive episodes (odds ratio 1.5 vs. manic episodes alone; 1.8 vs. depressive episodes alone). In addition, migraine comorbidity was associated with different correlates depending on the specific combination of mood episodes; in subjects with both manic and depressive episodes, migraine comorbidity was associated with an earlier onset of mental illness, while in subjects with either manic or depressive episodes alone, migraine comorbidity was associated with increased suicidality and anxiety. CONCLUSIONS Migraine comorbidity appears to delineate a subset of individuals with earlier onset of affective illness and more psychiatric complications, suggesting that migraine assessment in mood disorder patients may be useful as an indicator of potential clinical severity. Differences in the prevalence of migraine as well as sociodemographic and clinical correlates associated with specific combinations of mood episodes underscore the importance of examining this comorbidity by specific type of mood episode.
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Affiliation(s)
- Tuong-Vi Nguyen
- Department of Psychiatry, McGill University Research and Training Building, McGill University, Montreal, QC, Canada.
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14
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Abstract
PURPOSE OF REVIEW Recent evidence supports the suggestion that migraine is a chronic disorder with episodic attacks that increase in frequency in a subgroup of patients, transforming migraine into a refractory chronic condition with poor outcome and severe impact. Among the risk factors for migraine chronification depression figures notably. Early diagnosis and management of risk factors in migraineurs prevent migraine chronification and its consequences. The scope of this article is to review depression as a potential cofactor for migraine chronification. RECENT FINDINGS Population-based studies revealed that migraineurs often have symptoms of depression, with strongest associations for migraine with aura. Patients with depression also have an increased risk for migraine, migraine with aura in particular. Twin studies showed similar findings. This bidirectional relationship suggests that migraine and depression may share common causative factors, possibly genetically determined, that might control migraine chronification. Migraine patients may develop depression as a result of the demoralizing experience of recurrent and disabling headaches and depressed patients may develop migraine because of increased pain sensitivity, in the basis of a common genetic background. SUMMARY We suggest that clinicians consider depression as part of migraine management in order to optimize treatment and avoid migraine progression.
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Hung CI, Liu CY, Yang CH, Wang SJ. Negative impact of migraine on quality of life after 4 weeks of treatment in patients with major depressive disorder. Psychiatry Clin Neurosci 2012; 66:8-16. [PMID: 22250605 DOI: 10.1111/j.1440-1819.2011.02286.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The impact of migraine on health-related quality of life (HRQoL) among patients with major depressive disorder (MDD) after acute antidepressant treatment has not been addressed. The aim of the present study was to investigate whether or not the negative impact of migraine on HRQoL among outpatients with MDD continued to have an effect after 4 weeks of venlafaxine treatment. METHODS A total of 135 outpatients with MDD were enrolled, who were then treated with venlafaxine 75 mg per day for 4 weeks in the present open-label study. Migraine was diagnosed based on the International Classification of Headache Disorders (2nd edn). Changes in Short-Form 36 (SF-36) and Hamilton Depression Rating Scale (HAMD) scores were the outcome measures. Multiple linear regression was used to assess whether migraine was an independent factor predicting SF-36 score after treatment. RESULTS Seventy-two participants (18M/54F) completed the 4-week treatment. Subjects with migraine had a poorer HRQoL in terms of bodily pain and mental health at baseline. Subjects with and without migraine showed significant improvement in all SF-36 subscales and depression after treatment, but subjects with migraine still had a poorer HRQoL regarding bodily pain and physical functioning after treatment as compared with those without migraine. Migraine could predict a negative outcome after treatment in the subscales of physical functioning, role limitations-physical, and role limitations-emotional. CONCLUSIONS Migraine may have a negative impact on the improvement of partial SF-36 subscales, especially on functional recovery, after acute treatment among outpatients with MDD. Whether additional intervention besides antidepressant treatment for migraine is indicated may need further study.
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Affiliation(s)
- Ching-I Hung
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taipei, Taiwan
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16
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Liang J, Yu S, Dong Z, Wang X, Liu R, Chen X, Li Z. The effects of OB-induced depression on nociceptive behaviors induced by electrical stimulation of the dura mater surrounding the superior sagittal sinus. Brain Res 2011; 1424:9-19. [DOI: 10.1016/j.brainres.2011.09.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 09/22/2011] [Accepted: 09/22/2011] [Indexed: 12/15/2022]
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Nociceptive and anxiety-like behavior in reproductively competent and reproductively senescent middle-aged rats. ACTA ACUST UNITED AC 2010; 6 Suppl 2:235-46. [PMID: 19406372 DOI: 10.1016/j.genm.2009.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2008] [Indexed: 01/12/2023]
Abstract
BACKGROUND Changes in levels of estradiol and progesterone that occur with the transition to reproductive senescence may influence nociception or affect. OBJECTIVE To ascertain whether nociceptive and affective processes change with reproductive senescence, this study examined pain and anxiety-like behaviors in middle-aged female rats that were reproductively competent, transitioning to reproductive senescence, or reproductively senescent. METHODS Middle-aged (12-14 months old) female rats (N = 46) were tested in the following tasks to assess pain and anxiety-like behavior: tail flick, elevated plus maze, elevated zero maze, mirror maze, Vogel punished drinking, and defensive burying. For the tail-flick task, the latency for rats to move their tail from a heat source, as an indication of pain sensitivity, was determined. In the elevated plus and elevated zero mazes, the time spent on the open arms or quadrants, respectively, were determined as measures of reduced anxiety behavior. In the mirror maze, the time spent in the mirrored portion of the chamber was used as an indicator of anxiety-like responding. In the Vogel task, the number of punished licks made was determined as a measure of reduced anxiety-like behavior. In the defensive burying task, the duration spent by rats burying an electrified prod postfootshock was utilized as an index of anxietylike responding. All rats were experimentally naive, retired breeders from our colony and had not had a litter or been lactating for 1 to 4 weeks before behavioral testing. RESULTS Although tail-flick latencies were not significantly different among rats that were reproductively competent or senescent, reproductively competent rats had less anxiety-like behavior in the elevated plus maze (more time spent on the open arms: F(2,43) = 5.93; P < 0.01), elevated zero maze (more time spent on the open quadrants: F(2,43) = 4.62; P = 0.01), and Vogel punished drinking task (more punished licks made: F(2,43) = 3.76; P = 0.03). There were no statistically significant differences in the mirror maze and defensive burying task. CONCLUSION In this study of adult female rats, nociceptive behavior did not vary significantly with reproductive senescence, but anxiety-like behavior of rats did.
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Beghi E, Bussone G, D'Amico D, Cortelli P, Cevoli S, Manzoni GC, Torelli P, Tonini MC, Allais G, De Simone R, D'Onofrio F, Genco S, Moschiano F, Beghi M, Salvi S. Headache, anxiety and depressive disorders: the HADAS study. J Headache Pain 2010; 11:141-50. [PMID: 20108021 PMCID: PMC3452290 DOI: 10.1007/s10194-010-0187-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 12/26/2009] [Indexed: 11/26/2022] Open
Abstract
The objective of this paper was to assess prevalence and characteristics of anxiety and depression in migraine without aura and tension-type headache, either isolated or in combination. Although the association between headache and psychiatric disorders is undisputed, patients with migraine and/or tension-type headache have been frequently investigated in different settings and using different tests, which prevents meaningful comparisons. Psychiatric comorbidity was tested through structured interview and the MINI inventory in 158 adults with migraine without aura and in 216 persons with tension-type headache or migraine plus tension-type headache. 49 patients reported psychiatric disorders: migraine 10.9%, tension-type headache 12.8%, and migraine plus tension-type headache 21.4%. The MINI detected a depressive episode in 59.9, 67.0, and 69.6% of cases. Values were 18.4, 19.3, and 18.4% for anxiety, 12.7, 5.5, and 14.2%, for panic disorder and 2.3, 1.1 and 9.4% (p = 0.009) for obsessive–compulsive disorder. Multivariate analysis showed panic disorder prevailing in migraine compared with the other groups (OR 2.9; 95% CI 1.2–7.0). The association was higher (OR 6.3; 95% CI 1.4–28.5) when migraine (with or without tension-type headache) was compared to pure tension-type headache. This also applied to obsessive–compulsive disorder (OR 4.8; 95% CI 1.1–20.9) in migraine plus tension-type headache. Psychopathology of primary headache can reflect shared risk factors, pathophysiologic mechanisms, and disease burden.
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Affiliation(s)
- Ettore Beghi
- Dipartimento di Neuroscienze, Istituto Mario Negri, Milan, Italy.
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Guidetti V, Galli F, Sheftell F. Headache attributed to psychiatric disorders. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:657-62. [PMID: 20816461 DOI: 10.1016/s0072-9752(10)97055-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The association between psychiatric illness and headache is widely recognized. "Headache attributed to psychiatric disorder" is a new category of secondary headache introduced in the 2004 revision of the International Classification of Headache Disorders (ICHD-II) (Headache Classification Subcommittee of the International Headache Society, 2004). It represents a new, but not conclusive, step toward a better systematization of the topic "headache and psychological factors." From the early 1990s the involvement of psychological factors in headache disorders has been clearly identified as "psychiatric comorbidity." The current conceptualization of the term implies an association, more than casual, but likely not causal, between an index disease or disorder and one or more coexisting physical or psychological pathologies. Additionally, clarifying the direction, meaning, and weight of comorbidities has pathophysiological, nosological, course, and treatment implications. However, the study of comorbidity may present a series of difficulties related to the current understanding of the etiology and pathophysiology of diseases at the center of our attention. Sometimes, as happens in the subject of headache, we proceed against a background where many issues need to be clarified. In this chapter, we analyze the past and current literature, tracing the line from "migraine personality" to "psychiatric comorbidity" to "headache attributed to psychiatric disorders." Questions related to etiology, pathophysiology, and treatment options are discussed for different headache subtypes.
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Affiliation(s)
- Vincenzo Guidetti
- Department of Child and Adolescent Neurology, Psychiatry and Rehabilitation, "Sapienza", University of Rome, Rome, Italy.
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20
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Migraine: a missing link between somatic symptoms and major depressive disorder. J Affect Disord 2009; 117:108-15. [PMID: 19167091 DOI: 10.1016/j.jad.2008.12.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 12/13/2008] [Accepted: 12/13/2008] [Indexed: 11/21/2022]
Abstract
BACKGROUND Research into the role of migraine in somatic symptoms of major depressive disorder (MDD) has long been neglected; hence, the aim of this study was to compare the impact of migraine and anxiety comorbidities on the somatic symptoms of patients with MDD. METHODS Consecutive psychiatric outpatients with MDD in a medical center were enrolled. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR; migraine was diagnosed according to the International Classification of Headache Disorders, 2nd edition. Four scales were administered and evaluated: the Hamilton Depression Rating Scale, the Depression and Somatic Symptoms Scale, the somatization subscale of the Symptom Checklist-90-Revised, and the Hospital Anxiety and Depression Scale. Multiple linear regressions were used to find the most powerful comorbidities in predicting somatic symptoms. RESULTS One hundred and fifty five patients (106F, 49M) completed the study. Subjects with migraine had higher somatic, depression and anxiety severities. Panic disorder was the most important factor when predicting somatic severity among anxiety comorbidities. Migraine (R(2) change=0.28 to 0.04, p<.01) was the strongest independent factor in predicting somatic severity, even after controlling for anxiety comorbidities and demographic variables. LIMITATIONS This study used certain exclusion criteria when enrolling MDD outpatients, possibly introducing bias. CONCLUSIONS Comorbidity with migraine was found to be associated with more somatic symptoms in patients with MDD, and migraine was a strong and independent predictor for the somatic symptoms of MDD. Future studies on the somatic symptoms of MDD should therefore take migraine into consideration.
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Victor TW, Hu X, Campbell J, White RE, Buse DC, Lipton RB. Association between migraine, anxiety and depression. Cephalalgia 2009; 30:567-75. [DOI: 10.1111/j.1468-2982.2009.01944.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Logistic regression was used to evaluate the relationship between self-reported medical diagnosis of migraine, self-reported depressive symptomology (RDS) and self-reported anxious symptomology (RAS) in the National Health Interview Survey ( n = 30 852). Semipartial squared correlations evaluated the population-level variability between RDS, RAS and migraine impairment. Migraine prevalence was 15.2% (overall), 20.5% (women) and 9.4% (men). Migraine risk was higher in participants with RAS [odds ratio (OR) 2.30, 95% confidence interval (CI) 2.09, 2.52), with RDS (OR 2.23, 95% CI 1.93, 2.58), who smoked (OR 1.19, 95% CI 1.09, 1.30), or who consulted a mental health provider (OR 1.45, 95% CI 1.27, 1.65). Although migraine risk was increased in both women (OR 1.93) and men (OR 2.42) with RAS ( P < 0.001), men with RAS had a higher migraine risk than did women with RAS ( P < 0.001). Only 7% of the variability in migraine impairment (population level) was predicted by variability in RDS and/or RAS.
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Affiliation(s)
- TW Victor
- Endo Pharmaceuticals Inc., Chadds Ford, PA, USA
| | - X Hu
- Endo Pharmaceuticals Inc., Chadds Ford, PA, USA
| | - J Campbell
- Endo Pharmaceuticals Inc., Chadds Ford, PA, USA
| | - RE White
- Endo Pharmaceuticals Inc., Chadds Ford, PA, USA
| | - DC Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
- The Montefiore Headache Center, Bronx, NY, USA
| | - RB Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
- The Montefiore Headache Center, Bronx, NY, USA
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Hung CI, Liu CY, Chen JJ, Wang SJ. Migraine predicts self-reported muscle tension in patients with major depressive disorder. PSYCHOSOMATICS 2009; 49:502-10. [PMID: 19122127 DOI: 10.1176/appi.psy.49.6.502] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVE The aim of this study was to identify factors related to muscle tension in patients with major depressive disorder (MDD) with comorbid anxiety and migraine. METHOD Consecutive psychiatric outpatients with MDD were enrolled. Self-reported muscle tension (SMT) during the previous week was evaluated with a 0-10 scale. RESULTS Of 135 participants with MDD, 63 (46.7%) had migraine. Multiple-regression analyses showed that migraine and headache intensity were two major independent factors related to SMT. CONCLUSION Further studies on musculoskeletal symptoms in MDD should not neglect the impact of migraine.
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Affiliation(s)
- Ching-I Hung
- The Neurological Institute, Taipei Veterans General Hospital, 201 Shi-Pai Rd., Section 2, Taipei 112, Taiwan
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The impact of anxiety and migraine on quality of sleep in patients with major depressive disorder. Compr Psychiatry 2009; 50:151-7. [PMID: 19216892 DOI: 10.1016/j.comppsych.2008.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Revised: 07/06/2008] [Accepted: 07/09/2008] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the impact of anxiety disorders and migraine on sleep quality and to find the independent factors that predict sleep quality among patients with major depressive disorder (MDD). METHOD Psychiatric outpatients diagnosed with MDD were enrolled in the study. Major depressive disorder and 7 anxiety disorders were diagnosed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Migraine was diagnosed based on the International Classification of Headache Disorders, Second Edition. Headache intensity and frequency were reported by the subjects. The Pittsburgh Sleep Quality Index and Hamilton Depression Rating Scale were used to evaluate quality of sleep and depression severity, respectively. Multiple linear regressions were used to identify independent factors related to sleep quality. RESULTS One hundred thirty-five subjects (34 men and 101 women) with MDD were enrolled in the study. Subjects with panic disorder and agoraphobia were found to have poorer Pittsburgh Sleep Quality Index scores. Subjects with panic disorder, agoraphobia, and migraine had higher scores for items relating to sleep quality in the Hamilton Depression Rating Scale. Headache intensity and frequency correlated with sleep disturbance. Panic disorder was independently predictive of poor sleep quality. Both migraine and panic disorder independently predicted a greater severity of depression. CONCLUSION Our study demonstrates the negative impact of panic disorder and migraine on MDD and some of the interrelations between depression, anxiety, and sleep quality. Future studies should further explore these interactions and consider possible therapeutic interventions.
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Remission of migraine attacks in a patient with depression who is taking pregabalin. Clin Neuropharmacol 2008; 31:238-40. [PMID: 18670248 DOI: 10.1097/wnf.0b013e31814a62e1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Antiepileptic drugs (AED) are increasingly used in the treatment of migraine. Pregabalin (PGB) is an AED that has been used in the treatment of partial seizures, of various types of pain, and of certain anxiety disorders, but to the best of our knowledge, there has been no report on the use of PGB in the treatment of migraine. We report the case of a 60-year-old female inpatient with depression, long experiencing migraine, whose migraine symptoms improved markedly after receiving PGB in combination with escitalopram administered for her depression. The PGB mechanism of action in conjunction with its structural similarity with gabapentin, already successfully tested in the treatment of migraine, provide additional supportive evidence, theoretical and clinical, respectively, for PGB potential to alleviate migraine symptoms. However, only carefully randomized, controlled studies, or at the very least, open-label series of large patient samples treated in a similar fashion could establish the efficacy of PGB in migraine treatment.
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Diener HC, Küper M, Kurth T. Migraine-associated risks and comorbidity. J Neurol 2008; 255:1290-301. [PMID: 18958572 DOI: 10.1007/s00415-008-0984-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2008] [Revised: 04/21/2008] [Accepted: 04/22/2008] [Indexed: 10/21/2022]
Abstract
This review reports important co-morbid conditions of migraine and resulting consequences for the choice of acute and preventive treatments of migraine. Comorbidity in this context means the occurrence of two diseases in an individual beyond chance. The basis of comorbidity can be genetic and/or based on common environmental factors. In some cases, the temporal relationship is unclear and one disease can cause another disease. In order to prove a real comorbidity, large-scale and well-performed epidemiological studies are required.
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Affiliation(s)
- H C Diener
- Dept. of Neurology and Headache Center, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
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The impacts of migraine, anxiety disorders, and chronic depression on quality of life in psychiatric outpatients with major depressive disorder. J Psychosom Res 2008; 65:135-42. [PMID: 18655858 DOI: 10.1016/j.jpsychores.2008.04.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Revised: 01/27/2008] [Accepted: 04/30/2008] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Our purpose was to determine if migraine, anxiety comorbidities, and chronic depression were independently related to health-related quality of life (HRQoL) in outpatients with major depressive disorder (MDD). METHOD Consecutive psychiatric outpatients with MDD in a medical center were enrolled. MDD, chronic depression, and seven anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. Migraine was diagnosed based on the International Classification of Headache Disorders, 2nd edition. The acute version of the Short-Form 36 and the Hamilton Depression Rating Scale (HAMD) were used to evaluate the HRQoL and the severity of depression, respectively. Multiple linear regressions were used to determine the independent factors related to HRQoL. RESULTS There were 135 participants (34 men, 101 women) with MDD. Subjects with migraine, anxiety comorbidities, or chronic depression had higher HAMD scores and poor HRQoL. Migraine, specific phobia, and panic disorder were important and independent comorbidities predicting HRQoL. The impact of migraine on HRQoL, especially on bodily pain, was not inferior to those of some anxiety comorbidities or chronic depression. CONCLUSION Future studies related to HRQoL of MDD should consider migraine and anxiety comorbidities simultaneously.
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Precipitating or aggravating factors for headache in patients with major depressive disorder. J Psychosom Res 2008; 64:231-5. [PMID: 18222138 DOI: 10.1016/j.jpsychores.2007.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2007] [Revised: 05/26/2007] [Accepted: 08/17/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the common precipitating or aggravating factors for headache among patients with major depressive disorder (MDD) and to compare precipitating or aggravating factors specifically for migraine with those for other headaches. METHODS Consecutive psychiatric outpatients with MDD in a medical center were enrolled. Headaches were diagnosed based on the International Classification of Headache Disorders, 2nd Edition. A 21-item self-report questionnaire was used to identify precipitating or aggravating factors. Subjects were divided into migraine and other-headache groups. RESULTS Of 122 subjects (76% female) with headache, 63 (51.6%) were diagnosed with migraine. Mental stress and depressive symptoms were the most common precipitating or aggravating factors, and 17 factors affected >50% of the subjects. Compared with other-headache groups, the migraine group was more sensitive to emotional and perceptional stimuli and to the stress of daily activities. CONCLUSION Treatment of depression and education of depressed patients about how to cope with mental stress might help to eliminate the negative impact of headache.
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Hung CI, Weng LJ, Su YJ, Liu CY. Depression and somatic symptoms scale: a new scale with both depression and somatic symptoms emphasized. Psychiatry Clin Neurosci 2006; 60:700-8. [PMID: 17109704 DOI: 10.1111/j.1440-1819.2006.01585.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors' preliminary study selected 22 items for Depression and Somatic Symptoms Scale (DSSS), including depression subscale (DS) and somatic subscale (SS). The aim of the study was to test reliability and validity of the DSSS. The study enrolled 135 consecutive outpatients (34 male and 101 female) experiencing a major depressive episode (the MDE group), 95 of whom (25 male and 70 female) accepted 1 month of treatment (the treatment group). Diagnosis was confirmed by using the Structured Clinical Interview for 4(th) edition with text revision Diagnostic and Statistical Manual Axis I Disorders. The DSSS and Hamilton Depression Rating Scale (HAMD) were given and evaluated. Cronbach's alpha was used to assess internal consistency. The correlation between the improvement percentage (IP) for the HAMD and the IP for the DSSS was calculated for the treatment group. Factor analysis was performed by using the principal-axis factoring method with promax rotation. Cronbach's alpha values of the DSSS and its subscales ranged from 0.73 to 0.94. Pearson correlation coefficients for the relationship between the DSSS and HAMD ranged from 0.63 to 0.86. In the treatment group, DSSS and HAMD scores were significantly decreased after treatment and the IP for the HAMD and the DSSS were similar and correlated (correlation coefficient = 0.78). The results of the factor analysis demonstrated that most of the items in DS and SS appropriately loaded in Depression and Somatic factors, respectively. The discriminative ability of the DSSS for anxiety comorbidities was not inferior to that of the HAMD. Therefore, the DSSS is reliable and sensitive to the treatment and has acceptable convergent, factorial, and distinct-groups validities. Because it assesses both depression and somatic symptoms, DSSS may overcome the deficiency of other depression scales with few somatic items.
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Affiliation(s)
- Ching-I Hung
- Department of Psychiatry, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
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