Migraine in Pediatric Patients Associated With Anxiety, Depressive Disorders

In a systematic review and meta-analysis, researchers found an association between anxiety, depressive disorders, and migraine in children and adolescents.

“Our results underscore the need to screen for mental health symptoms, particularly anxiety and depression in any child or adolescent presenting with migraine, and then to do something about it,” said Serena Orr, MD, MSc, a pediatric neurologist and headache specialist at the Alberta Children’s Hospital in Calgary, Alberta, Canada, in an interview with Consultant360.

Dr Orr and her team analyzed 80 observational studies that met their criteria. Eligible studies were case-controlled, cohort, and cross-sectional studies that looked at the association between internalizing symptoms and disorders and migraine. Participants in the studies were children and adolescents aged 18 years or younger.

In total, 4946 studies were screened and narrowed down to the 80 studies used for the researchers’ analysis. When comparing children and adolescents with migraine to healthy controls, the researchers found an association between migraine and anxiety symptoms as well as an association between migraine and depressive symptoms.

Further, when comparing those with and without migraine, there were higher odds of anxiety and depressive disorders in those with migraine.

Orr and colleagues noted that “it may be beneficial to routinely screen children and adolescents” based on the results of their study.

“[Our study includes] high level data to support the clinical recommendation to screen for anxiety and depressive symptoms in children, adolescents with migraine,” Dr Orr told Consultant360.

But Dr Orr also reiterated that gaps in our knowledge remain.

“We don't know if mental health impacts outcomes,” she continued. “We don't know if the mental health symptoms lead to the development of migraine, or vice versa or neither. And so, although we know there's an association, there's still many unanswered questions, and we shouldn't bias our clinical practice by assuming the answers to some of those questions.”

Interested in more expert perspective? Watch the full interview with Serena Orr, MD, MSc here.

Reference:

Falla K, Kuziek J, Mahnaz SR, Noel M, Ronksley PE, Orr SL. Anxiety and depressive symptoms and disorders in children and adolescents with migraine. JAMA Pediatr. 2022;176(12):1176-1187. doi:10.1001/jamapediatrics.2022.3940