Children, Adolescents With Migraine Associated With Anxiety, Depressive Symptoms

Children and adolescents who experience migraines are at higher risk of anxiety and depression symptoms and disorders, according to a study.

The study aimed to determine the link between anxiety and depressive symptoms and disorders, and migraine to encourage symptom screening by clinicians as it may be beneficial to do so.

Researchers conducted a systematic review and meta-analysis that included 80 observational studies. Their data search was performed using MEDLINE, Embase, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), which are all medical databases. In total, 4946 studies were screened before the researchers narrowed it down to 51 studies to analyze.

In comparison to children and adolescents without migraine, the researchers found an association between migraine and anxiety symptoms (standardized mean differences [SMD] = 1.13; 95% CI, 0.64 – 1.63), and an association between migraine and depressive symptoms (SMD = 0.67; 95% CI, 0.46 – 0.87).

Additionally, children and adolescents with migraine have a higher chance of being diagnosed with anxiety disorders (odds ratio [OR] = 1.93, 95% CI, 1.49 – 2.50), and depressive disorders (OR = 2.01, 95% CI, 1.46 – 2.78) when compared to those without migraine.

There were limitations in this study, including the authors’ inability to further stratify results based on important covariates, such as headache frequency and sex, which the authors noted is a reflection on the inadequate stratified reporting in the original studies. Additionally, the authors noted that over a quarter (21 of 80 [26.3%]) of the studies had low quality ratings.

Still, the authors conclude that it might be worth screening children with migraines for anxiety or depression.

“It may be beneficial to routinely screen children and adolescents with migraine for anxiety and depression in clinical practice,” the researchers concluded. “It is unclear whether having anxiety and depressive symptoms or disorders has an effect on migraine outcomes or incidence.”

—Jessica Ganga

Reference:

Falla K, Kuziek J, Mahnaz SR, Noel M, Ronksley PE, Orr SL. Anxiety and depressive symptoms and disorders in children and adolescents with migraine. JAMA Pediatr. 2022;176(12):1176-1187. doi:10.1001/jamapediatrics.2022.2940