Psychiatric comorbidities in allodynic migraineurs

To evaluate the prevalence and the association of psychological disturbance in migraine patients with allodynia.

We recruited 434 migraine patients from an outpatient clinic. The participants completed three self-administered questionnaires, including a headache questionnaire, an allodynia symptoms checklist, and the Hospital Anxiety and Depression Scale (HADS).

Among the migraineurs, 48.4% participants reported allodynia. The HADS total score (15.5 ± 7.8 vs. 13.7 ± 8.5, P  = 0.022) and anxiety subscore (9.1 ± 4.5 vs. 7.6 ± 4.7, P  = 0.001) were higher in migraineurs with allodynia than in those without allodynia. The anxiety subscore in patients with moderate to severe allodynia, mild allodynia, and no allodynia were 10.0 ± 4.5, 8.4 ± 4.3, and 7.6 ± 4.7 ( P  < 0.001, by one-way analysis of variance). Among patients with moderate to severe allodynia, there was a trend of higher depression subscore (7.1 ± 4.0, P  = 0.059) than those with no (6.1 ± 4.4) or mild allodynia (5.8 ± 4.0). In a regression model, the presence of allodynia is an independent risk factor for clinically significant anxiety. Moderate to severe allodynia is an independent risk factor for clinically significant depression.

In migraineurs, the severity of cutaneous allodynia was associated with their mood status, especially anxiety.