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Migraine Increases the Risk for Major Depressive Episodes: Presented at IHS/AHS

By Liz Meszaros

PHILADELPHIA -- September 14, 2009 -- Migraine may be associated with an increased risk for experiencing major depressive episodes, although at the present time, the mechanism of this association is unknown, according to data presented here September 12 at the 14th Congress of the International Headache Society & the 51st Annual Scientific Meeting of the American Headache Society (IHS/AHS).

The association between migraine and depression has been examined by researchers for several years, as have the risks of combining migraine therapy with selective serotonin reuptake inhibitors.

For the national population-based study, Geeta Modgill, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, and colleagues used data from the Canadian National Population Health Survey (NPHS).

NPHS is a longitudinal study in which information is collected about the health of Canadians every 2 years. NPHS began in 1994 and includes 12 years of follow-up data.

During each cycle of interviews, participants were questioned about the presence of migraine and/or major depressive episodes.

NPHS participants who were free of major depressive episodes at baseline (1994) were divided into cohorts according to migraine status to help assess whether a history of migraine posed a risk of future major depressive episode. Researchers then used stratified analysis, logistic regression, and proportional hazard modelling to quantify the effect of migraine on subsequent major depressive episode status.

Of 13,175 eligible NPHS participants, 7,029 had no major depressive episodes at baseline and had completed follow-up to 2006. The overall cumulative incidence of major depressive episodes was 14.8% (95% confidence interval [CI], 13.7-15.9).

In participants with migraine, the risk of a major depressive episode was 22.2% (95% CI, 17.9-26.5). In addition, migraine had a significant effect on risk (hazard ratio [HR] = 2.1; 95% CI, 1.7-2.5; P < .001). When adjusted for gender, the HR was slightly reduced (HR = 1.9; 95% CI, 1.6-2.3; P < .001), which suggests that gender had a weak confounding effect on the results.

"Migraine is associated with the risk of major depressive episodes," said Modgill. "Migraine may contribute to the development of major depressive episodes or these 2 conditions may have shared causal determinants. Development of specialised interventions and services for this population may be warranted."

[Presentation title: Migraine Increases the Risk for Major Depressive Episodes: A National Population Based Study. Abstract LBPO04]

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