Children and adolescents with migraine have a higher risk for anxiety and depression symptoms and disorders compared with healthy controls, according to a systematic review and meta-analysis published online Oct. 31 in JAMA Pediatrics.
Katherine Falla, M.D., from the Cumming School of Medicine at the University of Calgary in Alberta, Canada, and colleagues conducted a systematic literature review to identify studies evaluating the association between anxiety and depressive symptoms and disorders and migraine in children and adolescents.
Based on 80 included studies, the researchers observed an association between migraine and anxiety symptoms (standardized mean difference, 1.13; 95 percent confidence interval, 0.64 to 1.63) and depressive symptoms (standardized mean difference, 0.67; 95 percent confidence interval, 0.46 to 0.87). Compared with children and adolescents without migraine, there were significantly higher odds of anxiety disorders (odds ratio, 1.93; 95 percent confidence interval, 1.49 to 2.50) and depressive disorders (odds ratio, 2.01; 95 percent confidence interval, 1.46 to 2.78) seen in those with migraine. No differences were observed between clinical and community-based populations, and there was no evidence of publication bias.
“These results have critical implications for clinical practice, underscoring the need to screen all children and adolescents with migraine for anxiety and depression,” the authors write. “Future work should address these questions and aim to determine whether trauma- and stressor-related symptoms and disorders are associated with migraine in children and adolescents.”