title: Migraine headaches and mood/anxiety disorders in the ELSA Brazil.
abstract: OBJECTIVE
  To describe the relationship between mood/anxiety disorders and migraine headaches emphasizing the frequency of episodes based in a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health.
  
  
  BACKGROUND
  It has been suggested that frequency of migraine headaches can be directly associated with the presence of psychiatric disorders.
  
  
  METHODS
  Migraine headaches (International Headache Society criteria) was classified as <1×/month, 1×/month-1×/week, 2-6×/week, and daily. Psychiatric disorders using the Clinical Interview Schedule - Revised were classified in 6 categories: common mental (CMD), major depressive (MDD), generalized anxiety (GAD), panic, obsessive-compulsive (OCD), and mixed anxiety and depressive (MADD) disorders. We performed multivariate logistic models adjusted for age, race, education, marital status, income, and use of selective serotonin reuptake inhibitors.
  
  
  RESULTS
  In our sample, 1261 presented definite migraine and 10,531 without migraine headaches (reference). Our main result was an increase in the strength of association between migraine and MDD as frequency of migraine increased for all sample: odds ratio of 2.14 (95% confidence interval [CI] 1.33-3.43) for <1 episode of migraine/month to 6.94 (95% CI 4.20-11.49) for daily headaches for all sample. Significant associations with migraine were also found for GAD, OCD, MADD, and CMD for total sample: MDD, GAD, OCD, MADD, and CMD for women, and MADD and CMD for men. Among men with daily migraine complaint, we found a significant association between migraine and OCD after correction for multiple comparisons (odds ratio 29.86 [95% CI 4.66-191.43]). Analyzing probable and definite migraine cases together, we replicated the findings in a lower magnitude.
  
  
  CONCLUSIONS
  The increase in migraine frequency was associated with progressively higher frequencies of having mood/anxiety disorders in all samples suggesting for some psychiatric disorders a likely dose-response effect especially for women.
authors.affiliation: Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Goulart
authors.forename: Itamar S
authors.initials: IS
authors.lastname: Santos
authors.forename: André R
authors.initials: AR
authors.lastname: Brunoni
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Nunes
authors.forename: Valéria M
authors.initials: VM
authors.lastname: Passos
authors.forename: Rosane H
authors.initials: RH
authors.lastname: Griep
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Benseñor
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology* / Q000523:psychology*; D019964:Mood Disorders / Q000453:epidemiology*; D015995:Prevalence
keywords: epidemiology; migraine; mood disorder