Beyond headache: Anxiety and depression in migraine – A cross-sectional study from a tertiary center in South India

Abstract

Migraine is known to be associated with a wide range of comorbidities, of which mood and anxiety disorders are 2–10 times more prevalent. Untreated comorbid psychiatric conditions in migraineurs can lead to a greater likelihood of chronification of migraine, making it important to identify the prevalence of these disorders in our population. To assess the prevalence and severity of anxiety and depression in migraine patients and examine their correlation with migraine severity. A cross-sectional, observational study conducted from July 2024 to December 2024 in the neurology outpatient department of a tertiary care hospital in Mangalore, Karnataka, using the International Classification of Headache-3 criteria. A total of 150 migraine patients aged 18–65 years were recruited via convenience sampling. Sociodemographic data were collected using a semistructured pro forma. Psychiatric symptoms were assessed using Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale. Migraine severity was evaluated using the Migraine Severity Scale. The mean age was 33.41 (±12.4) years. Anxiety was present in 22% and depression in 21.3% of participants. A strong positive correlation was found between migraine severity and both anxiety ( r = 0.474, P < 0.001) and depression ( r = 0.466, P < 0.001). Depression was significantly more prevalent in unmarried individuals and in those with longer migraine duration. Higher education was protective against depression. The high prevalence of psychiatric comorbidities in migraine underscores the need for integrated care. Routine screening and management of anxiety and depression can improve treatment outcomes and quality of life.