Abstract
There is a well-established comorbidity between migraine and anxiety and depression
(A/D). Here, we investigate whether this relationship is specific for migraine and
A/D or whether other types of pain are also consistently associated with A/D. In addition,
we test whether there is a consistent association between migraine and other types
of pain when comorbidity with A/D is controlled for. Data on A/D, migraine, and 6
nonheadache pain locations (back, neck, orofacial area, abdomen, joints, and chest)
were analyzed in 2,981 participants from the Netherlands Study of Depression and Anxiety
(NESDA). It was tested whether the prevalence of pain in each individual location,
as well as the total number of pain locations, depended on A/D and migraine status.
A/D was consistently associated with pain in all measured locations. Migraine was
also associated with pain in all anatomical sites, but these associations weakened
substantially after correction for A/D severity, suggesting that a considerable part
of the comorbidity of migraine and other types of pain may be explained by A/D. These
findings emphasize the importance of accounting for A/D in studies of pain comorbidity.
This will contribute to a better understanding of the mechanisms underlying A/D and
pain.
Perspective
Anxiety and depression are consistently associated with pain, regardless of anatomical
site. These disorders may be important factors in the co-occurrence of different pain
disorders. Awareness of this comorbidity and a better understanding of the underlying
mechanisms may facilitate adequate treatment of both types of conditions.
Key words
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References
- Diagnostic and Statistical Manual of Mental Disorders IV.American Psychiatric Publishing, Washington, DC2004
- The international classification of headache disorders, 2nd edition.Cephalalgia. 2004; 24: 9-160
- Comorbidity of other pains in schoolchildren with migraine or nonmigrainous headache.J Pediatr. 2001; 138: 176-180
- Depression and pain comorbidity: A literature review.Arch Intern Med. 2003; 163: 2433-2445
- Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients.Psychosom Med. 2008; 70: 890-897
- An inventory for measuring clinical anxiety: Psychometric properties.J Consult Clin Psychol. 1988; 56: 893
- BAI, Beck anxiety inventory: Manual.Psychological Corporation, San Antonio, TX1990
- Comorbidity of migraine and depression: Investigating potential etiology and prognosis.Neurology. 2003; 60: 1308-1312
- The prevalence of neck pain in migraine.Headache. 2010; 50: 1273-1277
- Chronic back pain and major depression in the general Canadian population.Pain. 2004; 107: 54-60
- Idiopathic pain disorders? Pathways of vulnerability.Pain. 2006; 123: 226-230
- Frequency and severity of the symptoms of irritable bowel syndrome across the anxiety disorders and depression.J Anxiety Disord. 2009; 23: 290-296
- Comorbidity of fibromyalgia with medical and psychiatric disorders.Am J Med. 1992; 92: 363-367
- Prevalence of fibromyalgia syndrome in migraine patients.Cephalalgia. 2006; 26: 451-456
- Sociodemographic and psychiatric determinants of attrition in the Netherlands Study of Depression and Anxiety (NESDA).Compr Psychiatry. 2011; 53: 63-70
- Sleep deprivation and pain perception.Sleep Med Rev. 2006; 10: 357-369
- Co-morbidity of migraine with somatic disease in a large population-based study.Cephalalgia. 2011; 31: 43-64
- The epidemiology of pain in depression.Hum Psychopharmacol. 2004; 19: S3-S7
- Association between major depressive disorder and heart rate variability in the Netherlands Study of Depression and Anxiety (NESDA).Arch Gen Psychiatry. 2008; 65: 1358-1367
- The shared genetics of migraine and anxious depression.Headache. 2010; 50: 1549-1560
- Migraine symptomatology and major depressive disorder.Cephalalgia. 2010; 30: 1073-1081
- Migraine, quality of life, and depression.Neurology. 2000; 55: 629-635
- Depression and anxiety associated with three pain conditions: Results from a nationally representative sample.Pain. 2004; 111: 77-83
- Migraine and psychopathology. Results of the Zurich cohort study of young adults.Arch Gen Psychiatry. 1990; 47: 849-853
- Migraine and depression: Association and familial transmission.J Psychiatr Res. 1988; 22: 119-129
- The Netherlands Study of Depression and Anxiety (NESDA): Rationale, objectives and methods.Int J Methods Psychiatr Res. 2008; 17: 121-140
- Abdominal migraine, another cause of abdominal pain in adults.Am J Med. 2012; 125: 1135-1139
- Depression and pain.Front Biosci. 2009; 14: 5031-5051
- The inventory for depressive symptomatology (IDS): Preliminary findings.Psychiatry Res. 1986; 18: 65-87
- The inventory of depressive symptomatology (IDS): Psychometric properties.Psychol Med. 1996; 26: 477-486
- Expectation of pain enhances responses to nonpainful somatosensory stimulation in the anterior cingulate cortex and parietal operculum/posterior insula: An event-related functional magnetic resonance imaging study.J Neurosci. 2000; 20: 7438-7445
- Does depression hurt?.J Clin Psychiatry. 2002; 63: 273-274
- The impact of migraine on quality of life in the general population: The GEM study.Neurology. 2000; 55: 624-629
- Comorbid depression and anxiety in fibromyalgia syndrome: Relationship to somatic and psychosocial variables.Psychosom Med. 2004; 66: 837-844
- Chronic spinal pain and physical-mental comorbidity in the United States: Results from the national comorbidity survey replication.Pain. 2005; 113: 331-339
- Grading the severity of chronic pain.Pain. 1992; 50: 133-149
- Reliability and validity studies of the WHO–Composite International Diagnostic Interview (CIDI): A critical review.J Psychiatr Res. 1994; 28: 57-84
- Depression and anxiety disorders associated with headache frequency. The Nord-Trondelag Health Study.Eur J Neurol. 2003; 10: 147-152
Article info
Publication history
Published online: February 07, 2013
Accepted:
December 7,
2012
Received in revised form:
December 3,
2012
Received:
March 29,
2012
Footnotes
The infrastructure for the NESDA study (www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organization for Health Research and Development (Zon-Mw, grant number 10-000-1002) and is supported by participating universities and mental health care organizations (VU University Medical Center, GGZ in Geest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Scientific Institute for Quality of Healthcare [IQ healthcare], Netherlands Institute for Health Services Research [NIVEL] and Netherlands Institute of Mental Health and Addiction [Trimbos Institute]). L.L. was supported by the EMGO + Institute for Health and Care Research and the European Research Council (ERC-230374).
All authors declare that they have no conflicts of interest.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
