Psychiatric comorbidity and paediatric migraine: examining the evidence

Psychiatric comorbidities are sometimes assumed in children with migraine. The goal of this review is to review the evidence for an association between psychiatric comorbidities and pediatric migraine.

Although depression or anxiety symptom scores may be higher in children with migraine who attend subspecialty clinics, the proportion of children with migraine who have clinically significant depression and anxiety is generally not elevated. In studies of children with migraine in the general population, the anxiety and depression scores are generally not elevated. Some of the scales used to measure anxiety and depression include questions about headaches and/or nausea, which makes them suboptimal tools for use in children with migraine as those are symptoms of migraine. Of note, depression was associated with incident development of chronic migraine in adolescents in one study.

The majority of children and adolescents with migraine do not have a comorbid psychiatric disorder. When a child with migraine does have a comorbid psychiatric disorder, it should be treated appropriately.