The impacts of migraine and anxiety disorders on painful physical symptoms among patients with major depressive disorder.
BACKGROUND
No study has simultaneously investigated the impacts of migraine and anxiety disorders on painful physical symptoms (PPS) among patients with major depressive disorder (MDD). The study aimed to investigate this issue.


METHODS
This open-label study enrolled 155 outpatients with MDD, who were then treated with venlafaxine 75 mg per day for four weeks. Eighty-five participants with good compliance completed the treatment. Migraine was diagnosed according to the International Classification of Headache Disorders. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale (VAS) was used to evaluate the severity of eight PPS. Multiple linear and logistic regressions were used to investigate the impacts of migraine and anxiety disorders on PPS.


RESULTS
Compared with patients without migraine, patients with migraine had a greater severity of PPS at baseline and post-treatment. After controlling for demographic variables and depressive severity, migraine independently predicted the intensities of eight PPS at baseline and four PPS post-treatment. Moreover, migraine independently predicted poorer treatment responses of chest pain and full remission of pains in the head, chest, neck and/or shoulder. Anxiety disorders predicted less full remission of pains in the abdomen and limbs.


CONCLUSIONS
Migraine and anxiety disorders have negative impacts on PPS among patients with MDD. Integrating the treatment of migraine and anxiety disorders into the management of depression might help to improve PPS and the prognosis of MDD.
Ching-I
CI
Hung
Chia-Yih
CY
Liu
Ching-Yen
CY
Chen
Ching-Hui
CH
Yang
Department of Neurology, National Yang-Ming University School of Medicine and Taipei Veterans General Hospital, No, 201 Shi-Pai Road, Section 2, Taipei 112, Taiwan. sjwang@vghtpe.gov.tw.
Shuu-Jiun
SJ
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000150:complications*; D003511:Cyclohexanols / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000188:drug therapy; D010146:Pain / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D010147:Pain Measurement; D063189:Symptom Assessment; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult
D000700:Analgesics; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride