Migraine: Comorbidity with depression

Objectives: To identify and see impact of coexisting depression in diagnosed cases of migraine. Design: Hospital-based case-control study. Setting: Department of Neurology, Jinnah Postgraduate Medical Centre Karachi. Patients and Methods: Patients of all ages and both sexes attending neurology OPD at JPMC between October 1998 to October 1999 were included. International Headache Society criteria for diagnosis of migraine and Urdu version of Hospital Anxiety and Depression Scale for diagnosis of depression was used. Migraine with Depression cases (MWD) were compared with Migraine without depression as controls (MC). Main-Outcome-Measures: Duration and frequency of migraine, co-morbidity with depression. Results: Out of 100 migraineurs, 40 were MWD and 40 MC were taken from the remaining 60 migraineurs. Among MWD and MC females were common: 72%(29) and 78%(31) respectively. Of the females MWD, most of the patients belonged to the age group 31-40years; 52%(15) patients, compared to MC where age group 21-30 years; 58%(18) was common. Among the mates, maximum number of migraineurs belonged to the age groups of 22-30 years for both MWD and MC i.e. 46%(05) and 56%(05) respectively. Fifty percent of MWD reported having migraine attacks for 10 or more years, whereas only 18% of MC had the similar duration. (P-value =<0.01). Ninety percent (n=36) of MWD reported maximal disability during the headache as compared to the 62.5%(25) of MC. 62.5%(25) of MWD had an average frequency of 4 or more attacks per month compare to 55%(22) of MC having once per month or less. (P-value =0.001). Conclusions: Migraineurs with long history and high frequency might benefit from psychiatric evaluation and addition of antidepressant drugs to their therapeutic regimen.