Depression and anxiety: Effect on the migraine-obesity relationship

Gretchen E. Tietjen, B. Lee Peterlin, Jan L. Brandes, Faizan Hafeez, Susan Hutchinson, Vincent T. Martin, Rima M. Dafer, Sheena K. Aurora, Michael R. Stein, Nabeel A. Herial, Christine Utley, Leah White, Sadik A. Khuder

Research output: Contribution to journalArticle

Abstract

Objective. - To discern the effects of depression and anxiety on the migraine-obesity relationship. Background. - Migraine and obesity are highly prevalent conditions and are both independently linked to psychiatric conditions, mainly depression and anxiety. Methods. - Data are from an ongoing cross-sectional multicenter study on comorbid conditions in clinic patients seeking treatment for headache. The diagnosis of migraine was determined by the examining physician based on the International Classification of Headache Disorders (ICHD)-II criteria. Participants completed a self-administered questionnaire with information on demographics, headache features, and physician-diagnosed comorbid medical and psychiatric disorders. The questionnaire included scales for measuring current depression (PHQ-9), anxiety (BAI), and headache-related disability (HIT-6). Results. - A total of 721 migraineurs (88% women) from 8 different headache treatment centers were included in this study (mean age = 42 years, SD = 12). Aura was reported in 45% and chronic headache (≥15 headache days/month) in 35% of the participants. Prevalence of obesity in our population was 30% and only 38% had normal weight. Obesity was more common in men (P =.004), African Americans (P =.026), and in lower education (P =.05) and household income (P =.05) groups. Current depression (PHQ-9 score ≥10) was noted in 42% and current anxiety (BAI score ≥8) in 70% of the obese migraineurs. In ordinal logistic regression, obesity was associated with current depression (odds ratio [OR] = 1.86, 95% confidence interval [CI]: 1.25 to 2.78) and anxiety (OR = 1.58, 95% CI: 1.12 to 2.22). A significant effect of depression on the body mass index (BMI) and headache frequency relationship was noted. Obese migraineurs with depression were more likely to have higher headache frequency (OR = 4.16, 95% CI: 1.92 to 8.99) and headache-related disability (OR = 7.10, 95% CI: 2.69 to 18.77) compared to normal weight migraineurs without depression. Similarly, obese migraineurs with anxiety were more likely to have higher headache frequency (OR = 1.96, 95% CI: 1.07 to 3.61) and headache-related disability (OR = 3.59, 95% CI: 1.64 to 7.86) compared to normal weight migraineurs without depression. Compared to migraineurs with either current depression or anxiety, those with both these conditions were more likely to have higher headache frequency (OR = 3.18, 95% CI: 1.86 to 5.43) and headache disability (OR = 6.13, 95% CI: 2.58 to 14.59). Conclusion. - Depression and anxiety were common in obese migraineurs. The relationship of obesity with migraine frequency and migraine-related disability is modified by depression and by anxiety, with the strongest effect observed in migraineurs with both depression and anxiety.

Original languageEnglish (US)
Pages (from-to)866-875
Number of pages10
JournalHeadache
Volume47
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Fingerprint

Migraine Disorders
Headache
Anxiety
Obesity
Depression
Odds Ratio
Confidence Intervals
Headache Disorders
Weights and Measures
Psychiatry
Physicians
African Americans
Multicenter Studies
Epilepsy
Body Mass Index
Cross-Sectional Studies
Logistic Models
Demography
Education

Keywords

  • Anxiety
  • Body mass index
  • Depression
  • Migraine
  • Obesity

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Tietjen, G. E., Peterlin, B. L., Brandes, J. L., Hafeez, F., Hutchinson, S., Martin, V. T., ... Khuder, S. A. (2007). Depression and anxiety: Effect on the migraine-obesity relationship. Headache, 47(6), 866-875. https://doi.org/10.1111/j.1526-4610.2007.00810.x

Depression and anxiety : Effect on the migraine-obesity relationship. / Tietjen, Gretchen E.; Peterlin, B. Lee; Brandes, Jan L.; Hafeez, Faizan; Hutchinson, Susan; Martin, Vincent T.; Dafer, Rima M.; Aurora, Sheena K.; Stein, Michael R.; Herial, Nabeel A.; Utley, Christine; White, Leah; Khuder, Sadik A.

In: Headache, Vol. 47, No. 6, 06.2007, p. 866-875.

Research output: Contribution to journalArticle

Tietjen, GE, Peterlin, BL, Brandes, JL, Hafeez, F, Hutchinson, S, Martin, VT, Dafer, RM, Aurora, SK, Stein, MR, Herial, NA, Utley, C, White, L & Khuder, SA 2007, 'Depression and anxiety: Effect on the migraine-obesity relationship', Headache, vol. 47, no. 6, pp. 866-875. https://doi.org/10.1111/j.1526-4610.2007.00810.x
Tietjen GE, Peterlin BL, Brandes JL, Hafeez F, Hutchinson S, Martin VT et al. Depression and anxiety: Effect on the migraine-obesity relationship. Headache. 2007 Jun;47(6):866-875. https://doi.org/10.1111/j.1526-4610.2007.00810.x
Tietjen, Gretchen E. ; Peterlin, B. Lee ; Brandes, Jan L. ; Hafeez, Faizan ; Hutchinson, Susan ; Martin, Vincent T. ; Dafer, Rima M. ; Aurora, Sheena K. ; Stein, Michael R. ; Herial, Nabeel A. ; Utley, Christine ; White, Leah ; Khuder, Sadik A. / Depression and anxiety : Effect on the migraine-obesity relationship. In: Headache. 2007 ; Vol. 47, No. 6. pp. 866-875.
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abstract = "Objective. - To discern the effects of depression and anxiety on the migraine-obesity relationship. Background. - Migraine and obesity are highly prevalent conditions and are both independently linked to psychiatric conditions, mainly depression and anxiety. Methods. - Data are from an ongoing cross-sectional multicenter study on comorbid conditions in clinic patients seeking treatment for headache. The diagnosis of migraine was determined by the examining physician based on the International Classification of Headache Disorders (ICHD)-II criteria. Participants completed a self-administered questionnaire with information on demographics, headache features, and physician-diagnosed comorbid medical and psychiatric disorders. The questionnaire included scales for measuring current depression (PHQ-9), anxiety (BAI), and headache-related disability (HIT-6). Results. - A total of 721 migraineurs (88{\%} women) from 8 different headache treatment centers were included in this study (mean age = 42 years, SD = 12). Aura was reported in 45{\%} and chronic headache (≥15 headache days/month) in 35{\%} of the participants. Prevalence of obesity in our population was 30{\%} and only 38{\%} had normal weight. Obesity was more common in men (P =.004), African Americans (P =.026), and in lower education (P =.05) and household income (P =.05) groups. Current depression (PHQ-9 score ≥10) was noted in 42{\%} and current anxiety (BAI score ≥8) in 70{\%} of the obese migraineurs. In ordinal logistic regression, obesity was associated with current depression (odds ratio [OR] = 1.86, 95{\%} confidence interval [CI]: 1.25 to 2.78) and anxiety (OR = 1.58, 95{\%} CI: 1.12 to 2.22). A significant effect of depression on the body mass index (BMI) and headache frequency relationship was noted. Obese migraineurs with depression were more likely to have higher headache frequency (OR = 4.16, 95{\%} CI: 1.92 to 8.99) and headache-related disability (OR = 7.10, 95{\%} CI: 2.69 to 18.77) compared to normal weight migraineurs without depression. Similarly, obese migraineurs with anxiety were more likely to have higher headache frequency (OR = 1.96, 95{\%} CI: 1.07 to 3.61) and headache-related disability (OR = 3.59, 95{\%} CI: 1.64 to 7.86) compared to normal weight migraineurs without depression. Compared to migraineurs with either current depression or anxiety, those with both these conditions were more likely to have higher headache frequency (OR = 3.18, 95{\%} CI: 1.86 to 5.43) and headache disability (OR = 6.13, 95{\%} CI: 2.58 to 14.59). Conclusion. - Depression and anxiety were common in obese migraineurs. The relationship of obesity with migraine frequency and migraine-related disability is modified by depression and by anxiety, with the strongest effect observed in migraineurs with both depression and anxiety.",
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TY - JOUR

T1 - Depression and anxiety

T2 - Effect on the migraine-obesity relationship

AU - Tietjen, Gretchen E.

AU - Peterlin, B. Lee

AU - Brandes, Jan L.

AU - Hafeez, Faizan

AU - Hutchinson, Susan

AU - Martin, Vincent T.

AU - Dafer, Rima M.

AU - Aurora, Sheena K.

AU - Stein, Michael R.

AU - Herial, Nabeel A.

AU - Utley, Christine

AU - White, Leah

AU - Khuder, Sadik A.

PY - 2007/6

Y1 - 2007/6

N2 - Objective. - To discern the effects of depression and anxiety on the migraine-obesity relationship. Background. - Migraine and obesity are highly prevalent conditions and are both independently linked to psychiatric conditions, mainly depression and anxiety. Methods. - Data are from an ongoing cross-sectional multicenter study on comorbid conditions in clinic patients seeking treatment for headache. The diagnosis of migraine was determined by the examining physician based on the International Classification of Headache Disorders (ICHD)-II criteria. Participants completed a self-administered questionnaire with information on demographics, headache features, and physician-diagnosed comorbid medical and psychiatric disorders. The questionnaire included scales for measuring current depression (PHQ-9), anxiety (BAI), and headache-related disability (HIT-6). Results. - A total of 721 migraineurs (88% women) from 8 different headache treatment centers were included in this study (mean age = 42 years, SD = 12). Aura was reported in 45% and chronic headache (≥15 headache days/month) in 35% of the participants. Prevalence of obesity in our population was 30% and only 38% had normal weight. Obesity was more common in men (P =.004), African Americans (P =.026), and in lower education (P =.05) and household income (P =.05) groups. Current depression (PHQ-9 score ≥10) was noted in 42% and current anxiety (BAI score ≥8) in 70% of the obese migraineurs. In ordinal logistic regression, obesity was associated with current depression (odds ratio [OR] = 1.86, 95% confidence interval [CI]: 1.25 to 2.78) and anxiety (OR = 1.58, 95% CI: 1.12 to 2.22). A significant effect of depression on the body mass index (BMI) and headache frequency relationship was noted. Obese migraineurs with depression were more likely to have higher headache frequency (OR = 4.16, 95% CI: 1.92 to 8.99) and headache-related disability (OR = 7.10, 95% CI: 2.69 to 18.77) compared to normal weight migraineurs without depression. Similarly, obese migraineurs with anxiety were more likely to have higher headache frequency (OR = 1.96, 95% CI: 1.07 to 3.61) and headache-related disability (OR = 3.59, 95% CI: 1.64 to 7.86) compared to normal weight migraineurs without depression. Compared to migraineurs with either current depression or anxiety, those with both these conditions were more likely to have higher headache frequency (OR = 3.18, 95% CI: 1.86 to 5.43) and headache disability (OR = 6.13, 95% CI: 2.58 to 14.59). Conclusion. - Depression and anxiety were common in obese migraineurs. The relationship of obesity with migraine frequency and migraine-related disability is modified by depression and by anxiety, with the strongest effect observed in migraineurs with both depression and anxiety.

AB - Objective. - To discern the effects of depression and anxiety on the migraine-obesity relationship. Background. - Migraine and obesity are highly prevalent conditions and are both independently linked to psychiatric conditions, mainly depression and anxiety. Methods. - Data are from an ongoing cross-sectional multicenter study on comorbid conditions in clinic patients seeking treatment for headache. The diagnosis of migraine was determined by the examining physician based on the International Classification of Headache Disorders (ICHD)-II criteria. Participants completed a self-administered questionnaire with information on demographics, headache features, and physician-diagnosed comorbid medical and psychiatric disorders. The questionnaire included scales for measuring current depression (PHQ-9), anxiety (BAI), and headache-related disability (HIT-6). Results. - A total of 721 migraineurs (88% women) from 8 different headache treatment centers were included in this study (mean age = 42 years, SD = 12). Aura was reported in 45% and chronic headache (≥15 headache days/month) in 35% of the participants. Prevalence of obesity in our population was 30% and only 38% had normal weight. Obesity was more common in men (P =.004), African Americans (P =.026), and in lower education (P =.05) and household income (P =.05) groups. Current depression (PHQ-9 score ≥10) was noted in 42% and current anxiety (BAI score ≥8) in 70% of the obese migraineurs. In ordinal logistic regression, obesity was associated with current depression (odds ratio [OR] = 1.86, 95% confidence interval [CI]: 1.25 to 2.78) and anxiety (OR = 1.58, 95% CI: 1.12 to 2.22). A significant effect of depression on the body mass index (BMI) and headache frequency relationship was noted. Obese migraineurs with depression were more likely to have higher headache frequency (OR = 4.16, 95% CI: 1.92 to 8.99) and headache-related disability (OR = 7.10, 95% CI: 2.69 to 18.77) compared to normal weight migraineurs without depression. Similarly, obese migraineurs with anxiety were more likely to have higher headache frequency (OR = 1.96, 95% CI: 1.07 to 3.61) and headache-related disability (OR = 3.59, 95% CI: 1.64 to 7.86) compared to normal weight migraineurs without depression. Compared to migraineurs with either current depression or anxiety, those with both these conditions were more likely to have higher headache frequency (OR = 3.18, 95% CI: 1.86 to 5.43) and headache disability (OR = 6.13, 95% CI: 2.58 to 14.59). Conclusion. - Depression and anxiety were common in obese migraineurs. The relationship of obesity with migraine frequency and migraine-related disability is modified by depression and by anxiety, with the strongest effect observed in migraineurs with both depression and anxiety.

KW - Anxiety

KW - Body mass index

KW - Depression

KW - Migraine

KW - Obesity

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