The need for inclusion of an anxiety screening tool during initial assessments of migraine patients has been highlighted by an Australian systematic review that confirmed a relationship between anxiety and migraine.
From an initial search of more than 2,000 citations, the review conducted by La Trobe University, Melbourne researchers, identified eight studies comparing anxiety outcomes in people 16 years and above, with and without migraine.
Validated anxiety screening tools used in the trials included the Goldberg Anxiety Disorder (GAD), Depression, Anxiety and Stress Score (DASS-21), Goldberg Anxiety Scale (GAS), Hamilton Anxiety Scale (HAS/HAMA), and self-reported anxious symptomology (RAS).
“In all the studies the results demonstrated a strong relationship in terms of Odds Ratios between anxiety and migraine compared to non-migraineurs. Both the Brazilian studies showed exceptionally high ORs (OR = 13 and 25…), with the other six studies showing ORs ranging from 1.77 to 4.5,” the review authors noted
“Clearly migraine and anxiety are comorbid, and the incidence of occurrence is almost four times higher compared to non-migraineurs.”
The study authors, writing in Frontiers in Neurology, said the findings suggested a joint predisposition or some related biological underpinnings in both migraine and anxiety.
It may also help explain why some anxiolytic medications work better than others for migraine mitigation.