Psychiatric comorbidities in allodynic migraineurs

Objectives: To evaluate the prevalence and the association of psychological disturbance in migraine patients with allodynia. Methods: 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). Results: 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. Conclusions: In migraineurs, the severity of cutaneous allodynia was associated with their mood status, especially anxiety.