title: Chronic pain and depression in the quality of life of women with migraine--a controlled study.
abstract: BACKGROUND
  Migraine is comorbid to depression and widespread chronic pain (WCP), but the influence of these conditions on the health-related quality of life (HRQoL) of individuals with episodic (EM) and chronic migraine (CM) is poorly understood.
  
  
  OBJECTIVE
  To assess the prevalence of depressive symptoms and WCP in individuals with EM and CM, as well as to estimate the joint impact of these conditions on the HRQoL of these individuals.
  
  
  METHODS
  All women aged 18 to 65 years with a first diagnosis of EM or CM from September of 2006 to September of 2008 seen in an outpatient headache service were invited to participate. They were asked to attend a separate appointment in the service, and to bring another woman of similar age that also agreed to participate. Depressive symptoms were assessed using the Beck Depression Inventory. Questions about WCP followed the protocol of the American College of Rheumatology. HRQoL was assessed using the Short-Form 36 (SF-36). Multivariate analysis modeled HRQoL as a function of headache status, depressive symptoms, and pain, using quantile regression.
  
  
  RESULTS
  Sample consisted of 179 women, 53 in the EM group, 37 in the CM group and 89 in control group. Groups did not differ by demographics. Mean scores of SF-36 were 53.6 (standard deviation [SD] = 23.5) for EM, 44.2 (SD = 18.5) for CM and 61.8 (SD = 21.5) for controls. In multivariate analysis, SF-36 scores were predicted by a CM status (P = .02; -10.05 [95% CI -18.52; -1.58]) and by a Beck Depression Inventory score (P < .01; -1.27 [95% CI -1.55; -0.99]). The influence of WCP in the SF-36 scores approached significance (P = .08; -0.78 [95% CI -1.64; 0.88]). Age did not contribute to the model.
  
  
  CONCLUSIONS
  Women with migraine are at an increased chance of WCP, and the chance increases as a function of headache frequency. Both depressive symptoms and CM independently predict HRQoL status.
authors.affiliation: Department of Neuroscience and Behavioral Science, School of Medicine at Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. juliana.dentista@gmail.com
authors.forename: Juliana
authors.initials: J
authors.lastname: Stuginski-Barbosa
authors.forename: Fabíola
authors.initials: F
authors.lastname: Dach
authors.forename: Marcelo
authors.initials: M
authors.lastname: Bigal
authors.forename: José G
authors.initials: JG
authors.lastname: Speciali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000523:psychology*; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D055815:Young Adult