title: Comorbidity of Migraine, Major Depressive Disorder, and Generalized Anxiety Disorder in Adolescents and Young Adults.
abstract: Depression and anxiety are highly comorbid psychiatric conditions and both are common in adult patients with migraine. This study aims to examine the unique associations between major depressive disorder (MDD) and generalized anxiety disorder (GAD) in a well-characterized group of older adolescents and college-age individuals with migraine.
  
  
  
  Participants (N =  227), between 15 and 20 years old, who were unmedicated or within 1 month of beginning antidepressant treatment underwent a comprehensive psychiatric assessment to establish the presence of MDD and GAD, according to the Diagnostic and Statistical Manual, Fourth Edition, Text Revision, and to rate their symptom severity using the Longitudinal Interval Follow-up Evaluation for Adolescents (A-LIFE). They then completed the ID-Migraine. The Student's t test and chi-square test were used to compare continuous and categorical variables, respectively, across participants with vs. without migraine. Logistic regression analysis examined the association between the presence of migraine and psychopathology.
  
  
  
  A diagnosis of MDD was associated with significantly increased risk of having migraine. Moreover, more severe and persistent ratings of depression were associated with an even higher likelihood of having migraine. A diagnosis of GAD was also significantly associated with the presence of migraine. The prevalence of comorbid MDD and GAD was significantly higher in participants with migraine than those without migraine (55 vs. 22%, p < 0.0001). When examined concurrently, GAD remained significantly associated with migraine, with a statistical trend for MDD to be associated with it.
  
  
  
  The comorbidity of migraine, MDD, and GAD has important clinical and research implications. Patients who suffer from any of these problems should be screened for all three in order to receive comprehensive care. Shared psychological and biological vulnerabilities may be involved in the three conditions. Greater understanding of the shared vulnerabilities can lead to unified treatments.
authors.affiliation: Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. lilian.dindo@bcm.edu.|Michael Debakey Veterans Affairs, Health Services Research and Development, Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA. lilian.dindo@bcm.edu.
authors.forename: Lilian N
authors.initials: LN
authors.lastname: Dindo
authors.affiliation: Department of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA.
authors.forename: Ana
authors.initials: A
authors.lastname: Recober
authors.affiliation: Department of Psychiatry, Washington University, Seattle, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Haddad
authors.affiliation: Menninger Department of Psychiatry and Behavioral Sciences, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 1102 Bates Ave, Suite 790, Houston, TX, 77030, USA. chadi.calarge@bcm.edu.
authors.forename: Chadi A
authors.initials: CA
authors.lastname: Calarge
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000523:psychology*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000523:psychology*; D015995:Prevalence; D055815:Young Adult
keywords: Adolescents; Anxiety; Depression; Migraine; Young adults