Migraine and Major Depression: A Seven-Year Bidirectional Cohort Study in Taiwan

Chien-Hsu Lai ； Yen-Yu Chen

《The Changhua Journal of Medicine》 16卷3期 (2018/09) Pp. 100-107

https://doi.org/10.6501/CJM.201809_16(3).0002

摘要

A bidirectional relationship between migraine and major depression has been observed; however, it is unclear whether the association varies among patients of differing age and gender. The aim of this study was to investigate the bidirectional risk relationship between migraine and major depression and to ascertain whether the association differs in patients of differing age and gender. We used a dataset containing records for one million patients obtained from the Longitudinal Health Insurance Database 2005, one of the main datasets of the National Health Insurance Research Database of Taiwan. The first part of this study included 1,785 patients with migraine diagnosed between January 1, 2000 and December 31, 2001, and a gender-, age-, hypertension-, and diabetes-matched comparison cohort three times larger than the migraine group. We tracked all patients from their index visit for up to seven years to detect any new diagnosis of major depression. The second part of this study included 2,589 major depression patients and a comparison cohort three times larger. All subjects were tracked to identify new diagnoses of migraine in the same way as for the first part of the study. Approximately 6.8% of the migraine patients and 1.8% of the comparison cohort developed major depression during the seven-year follow-up period. Cox proportional regression demonstrated a hazard ratio (HR) of 3.8 (95% confidence interval [CI] = 2.9–5.0) for the patients with migraine as compared with the comparison cohort. Similarly, 3.4% of the major depression patients and 1.3% of the comparison cohort received a new diagnosis of migraine during the seven-year follow-up period; the HR was 2.6 (95% CI = 1.9–3.4) for the patients with major depression. Our study demonstrated that migraine increases the risk of future development of major depression, and likewise major depression increases the risk of migraine. This bidirectional relationship between migraine and major depression was observed in the whole group and in all gender-specific and age-stratified groups.

關鍵字

depression ； migraine ； Taiwan