Migraine, quality of life, and depression - A population-based case-control study

Objective: This study reports on the influence of migraine and comorbid dep ression on health-related quality of life (HRQoL) in a population-based sam ple of subjects with migraine and nonmigraine controls. Methods: Two popula tion-based studies of similar design were conducted in the United States an d United Kingdom. A clinically validated, computer-assisted telephone inter view was used to identify individuals with migraine, as defined by the Inte rnational Headache Society, and a nonmigraine control group. During follow- up interviews, 389 migraine cases (246 US, 143 UK) and 379 nonmigraine cont rols (242 US, 137 UK) completed the Short Form (SF)-12, a generic HRQoL mea sure, and the Primary Care Evaluation of Mental Disorders, a mental health screening tool. The SF-12 measures HRQoL in two domains: a mental health co mponent score (MCS-12) and a physical health component score (PCS-12). Resu lts: In the United States and United Kingdom, subjects with migraine had lo wer scores (p < 0.001) on both the MCS-12 and PCS-12 than their nonmigraine counterparts. Significant differences were maintained after controlling fo r gender, age, and education. Migraine and depression were highly comorbid (adjusted prevalence ratio 2.7, 95% CI 2.1 to 3.5). After adjusting for gen der, age, and education, both depression sand migraine remained significant ly and independently associated with decreased MCS-12 and PCS-12 scores. HR QoL was significantly associated with attack frequency (for MCS-12 and PCS- 12) and disability (MCS-12). Conclusions: Subjects with migraine selected f rom the general population have lower HRQoL as measured by the SF-12 compar ed with nonmigraine controls. Further, migraine and depression are highly c omorbid and each exerts a significant and independent influence on HRQoL.