Comorbidity of Migraine and Depression - a Meta-analysis

The aim of the study: The aim of our study was to support the supposition of an association between migraine and depression. Methods: We reviewed 20 population-based cross-sectional studies focused on migraine in association with depression. For meta-analysis, we used odds ratio (OR) and random effects models. In the search for sources of heterogeneity, we. subdivided the studies on the basis of method of migraine and depression diagnosis, sampling, type of contact with subjects, and locality. The effect of proportional representation of females and sample size on OR variability was tested with meta-regression. Publication bias was verified by a funnel plot and by the Egger's regression test. Results: Three times higher incidence of depressive symptomology is expected in migraineurs compared with non-migraineurs (OR = 3.11; 95% CI 2.43-3.98). The effect of potential moderators was, apart from the difference in OR between studies with direct and indirect contact (Q(drf) = 6.32; p = 0.012), statistically insignificant. The OR variance was statistically significantly influenced by study size (Q(model) = 5.07; df = 1; p = 0.027). There was no evidence for publication bias as tested by the visual inspection of the funnel plot and by Egger's regression intercept (t = 1.92; df = 18; p = 0.10). Conclusion: The findings indicate strong comorbidity of migraine and depression. As depression is believed to be a risk factor for migraine chronification, monitoring of depressive symptomatology should be integral part of therapy.