Periodically, the press reports that migraineurs tend to get a depression. Right now this topic is reported in a number of countries (eg. the press release from Reuters 24 November 2011),
The news probably has one serious purpose, to sell antidepressants.
This time researchers from Canada have interviewed 15,000 adult Canadians via the phone and found that among migraineurs the risk of having a depression is up to twice the population average. We have heard the story before (from other research groups).
The 15,000 Canadians were contacted by telephone and asked if they had been diagnosed with migraines. They were also contacted one year prior to this study, and both times they were asked 14 questions which were intended to reveal whether they had experienced a severe depression in the past year. The interview used is called the CIDI-SF (Composite International Diagnostic Interview, Short Form), and is used by WHO as an indicator of mental health.
The questions are (in slightly abridged form):
The news probably has one serious purpose, to sell antidepressants.
This time researchers from Canada have interviewed 15,000 adult Canadians via the phone and found that among migraineurs the risk of having a depression is up to twice the population average. We have heard the story before (from other research groups).
The 15,000 Canadians were contacted by telephone and asked if they had been diagnosed with migraines. They were also contacted one year prior to this study, and both times they were asked 14 questions which were intended to reveal whether they had experienced a severe depression in the past year. The interview used is called the CIDI-SF (Composite International Diagnostic Interview, Short Form), and is used by WHO as an indicator of mental health.
The questions are (in slightly abridged form):
- Do you think that you have had a serious illness that doctors could not identify?
- Have you been so restless that you could not sit still?
- Have you felt more tired and without energy, even if you had not worked hard?
- Have you had trouble sleeping?
- Have you had trouble concentrating on anything you like, for example your work, reading the newspaper or watch television?
- Have you felt depressed and worthless?
- Have you felt that your life is not worth living?
- Have you felt guilty or regretted something you did?
- Have you felt that there was no hope for your future?
- Have you lost 5 kg without doing than work for it?
- Have you taken 5 kg on for no reason?
- Have you been sad or depressed?
- Have you become disenchanted with your hobbies, your work, gardening, playing with children or anything else that you would normally think is beautiful?
- Have you thought much about death?
The answer is yes, if you have had these experiences in most of the day, most days for 2 consecutive weeks.
If you answer yes to having had a non-definable disease and / or a period where everything was joyless and hopeless, you are well on the way to be qualified for the diagnosis of 'severe depression'. A few more yes answers, and the depression is certain.
This kind of study has been criticized by psychologists to overestimate the number of people with depression. For lay people, this is not surprising, because we all have periods with boyfriend troubles, bereavement and other radical shifts in our lives that make us say yes to some of the questions. Migraineurs who have had problems getting the diagnosis for their migraines from their physician, are bound to answer yes to the first question, and is thus well on its way to diagnose as depressed.
The Canadian study was slightly more selective than WHO and only applied the depression diagnosis if the participants were qualified based on the questions twice, with a year interval.
Migrænikerforbundet believes it is unprofessional to provide diagnoses of major depressive disorder based on questionnaires, which, by only a few 'wrong' answers, make the interviewed migraineurs classified as depressive.
Apart from the above mentioned problems with the doctor to get migraine diagnosed, migraineurs will often have trouble sleeping (due to pain), feel that life is not worth very much (as we have migraine) that we lack energy (after attacks) that it's hard to concentrate on much (when we have migraines) and migraine may exclude many of our future dreams from being fulfilled, so the future is not bright and happy. Preventive medicine gives weight changes, and we do not have the time and energy for hobbies and other fun, if time without migraine is scarce and we give priority to staying in our job, rather than personal time.
The Canadian study was conducted by telephone. This means that the interviewed persons did not get much chance to think about the answers. It is notoriously difficult to keep a cool head and remember that the impact of migraine (time scarcity, fatigue, guilt, sleep problems) has nothing to do with the possible depression the kind voice in the phone is talking about.
Science can be used and abused - and should not be used to impose an additional diagnosis of depression on migraineurs, if the sympotoms discovered are genuine consequences of having migraines.
This kind of study has been criticized by psychologists to overestimate the number of people with depression. For lay people, this is not surprising, because we all have periods with boyfriend troubles, bereavement and other radical shifts in our lives that make us say yes to some of the questions. Migraineurs who have had problems getting the diagnosis for their migraines from their physician, are bound to answer yes to the first question, and is thus well on its way to diagnose as depressed.
The Canadian study was slightly more selective than WHO and only applied the depression diagnosis if the participants were qualified based on the questions twice, with a year interval.
Migrænikerforbundet believes it is unprofessional to provide diagnoses of major depressive disorder based on questionnaires, which, by only a few 'wrong' answers, make the interviewed migraineurs classified as depressive.
Apart from the above mentioned problems with the doctor to get migraine diagnosed, migraineurs will often have trouble sleeping (due to pain), feel that life is not worth very much (as we have migraine) that we lack energy (after attacks) that it's hard to concentrate on much (when we have migraines) and migraine may exclude many of our future dreams from being fulfilled, so the future is not bright and happy. Preventive medicine gives weight changes, and we do not have the time and energy for hobbies and other fun, if time without migraine is scarce and we give priority to staying in our job, rather than personal time.
The Canadian study was conducted by telephone. This means that the interviewed persons did not get much chance to think about the answers. It is notoriously difficult to keep a cool head and remember that the impact of migraine (time scarcity, fatigue, guilt, sleep problems) has nothing to do with the possible depression the kind voice in the phone is talking about.
Science can be used and abused - and should not be used to impose an additional diagnosis of depression on migraineurs, if the sympotoms discovered are genuine consequences of having migraines.
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