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From the Departments of Neurology, Epidemiology, and Social Medicine (Dr. Lipton), Albert Einstein College of Medicine, Bronx, NY; Headache Unit (Dr. Lipton), Montefiore Medical Center, Bronx, NY; Innovative Medical Research (Dr. Lipton), Stamford, CT; the Department of Epidemiology (S.W. Hamelsky), New Jersey School of Public Health, University of Medicine and Dentistry of New Jersey, Piscataway; Innovative Medical Research (Drs. Kolodner and Stewart), Towson, MD; Division of Neuroscience (Dr. Steiner), Imperial College School of Medicine, London, UK; and Department of Epidemiology (Dr. Stewart), The Johns Hopkins University, Baltimore, MD.
Address correspondence and reprint requests to Dr. Richard B. Lipton, Innovative Medical Research, 1200 High Ridge Road, Stamford, CT 06905; e-mail: rlipton{at}imrinc.com
OBJECTIVE: This study reports on the influence of migraine and comorbid depression on health-related quality of life (HRQoL) in a population-based sample of subjects with migraine and nonmigraine controls.
METHODS: Two population-based studies of similar design were conducted in the United States and United Kingdom. A clinically validated, computer-assisted telephone interview was used to identify individuals with migraine, as defined by the International Headache Society, and a nonmigraine control group. During follow-up interviews, 389 migraine cases (246 US, 143 UK) and 379 nonmigraine controls (242 US, 137 UK) completed the Short Form (SF)–12, a generic HRQoL measure, and the Primary Care Evaluation of Mental Disorders, a mental health screening tool. The SF-12 measures HRQoL in two domains: a mental health component score (MCS-12) and a physical health component score (PCS-12).
RESULTS: In the United States and United Kingdom, subjects with migraine had lower scores (p < 0.001) on both the MCS-12 and PCS-12 than their nonmigraine counterparts. Significant differences were maintained after controlling for 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 gender, age, and education, both depression and migraine remained significantly and independently associated with decreased MCS-12 and PCS-12 scores. HRQoL was significantly associated with attack frequency (for MCS-12 and PCS-12) and disability (MCS-12).
CONCLUSIONS: Subjects with migraine selected from the general population have lower HRQoL as measured by the SF-12 compared with nonmigraine controls. Further, migraine and depression are highly comorbid and each exerts a significant and independent influence on HRQoL.
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