Depressive symptoms and migraine comorbidity among pregnant Peruvian women

Abstract

Background Migraine and depression are known to be comorbid conditions in non-pregnant women and men. However, the migraine-depression comorbidity among pregnant women, particularly women in developing countries has not been evaluated. Therefore, we evaluated the migraine-depressive symptom relationship in a large cohort of pregnant Peruvian women. Methods Women who delivered singleton infants (N=2,293) at the Instituto Nacional Materno Perinatal, Lima, Peru were interviewed during the postpartum hospital stay. Women were asked questions related to their lifetime and pregnancy experiences with headaches and migraines. Responses to these questions enabled the classification of “probable” and “strict” migraines according to the International Headache Society diagnostic criteria. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire Depression Subset. Logistic regression procedures were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Results Approximately 32% of the women reported a history of migraine, while 41% reported experiencing moderate to severe depressive symptoms during pregnancy. Compared with women without a history of migraine, women with strict migraine had AORs of 2.12 (95% CI 1.54–2.93), 1.85 (95% CI 1.16–2.96) and 2.23 (95% CI 1.08–4.62) for moderate, moderately severe and severe depressive symptoms, respectively. Conclusion This is the first report of a cross-sectional association between migraine and depressive symptoms in pregnant women. If our findings are confirmed, pregnant women with a history of migraine may benefit from increased vigilance for screening and treating depressive symptoms.

Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru

“…In the present study, the high prevalence of mood disorders and psychosocial stressors in Peru (e.g., antenatal depression, childhood abuse, and intimate partner violence) may account for the high prevalence of suicidal ideation (Cripe et al 2010; Farber et al 1996; Gavin et al 2011; Lindahl et al 2005; Perales et al 2009; WHO 2005). Of note, Devries et al (Devries et al 2011) found that intimate partner violence was a consistent risk factor for suicide behaviors even after adjusting for probable common mental disorders.…”

Comparative performance of Patient Health Questionnaire-9 and Edinburgh Postnatal Depression Scale for screening antepartum depression

“…The prevalence of antepartum depression ranges from 10% to 41% in LMICs (Organization, 2008). In a recent study, 41% of Peruvian women reported moderate to severe depressive symptoms during their entire pregnancy (Cripe et al, 2010). Depressive disorders during pregnancy are associated with adverse obstetric (de Paz et al, 2011, Qiu et al, 2007, Sanchez et al, 2013) and neonatal outcomes (Chung et al, 2001, Lou et al, 1994, Zuckerman et al, 1989).…”

“…Given the high prevalence of depressive symptoms during pregnancy in Peru (Cripe et al, 2010) and the lack of studies evaluating the comparability of the two scales during pregnancy, we conducted the present study to compare the psychometric properties of PHQ-9 and EPDS among pregnant Peruvian women. Specifically, as an initial step towards developing clinical intervention studies to mitigate the burden of depressive disorders among pregnant women in Peru, we sought to evaluate the construct validity of the two scales by evaluating their factor structures.…”

Depression, anxiety and stress among pregnant migraineurs in a pacific-northwest cohort

“…The co-occurrence of migraine and mood disorders has been well documented in non-pregnant populations (Breslau et al, 1994; Breslau et al, 2003; Fuller-Thomson et al, 2013; Gelaye et al, 2013; Jette et al, 2008; Kalaydjian and Merikangas, 2008; McWilliams et al, 2004; Merikangas et al, 1990; Nguyen and Low, 2013; Patel et al, 2004; Saunders et al, 2014; Swartz et al, 2000; Zwart et al, 2003). Recent evidence suggests that migraine and mood disorders may be common among pregnant women (Cripe et al, 2010; Williams et al, 2010). In a study of 2,293 pregnant women, 55.1% of migraineurs reported moderate to severe depressive symptoms during pregnancy compared to 36.7% of pregnant non-migraineurs (Cripe et al, 2010).…”

“…Recent evidence suggests that migraine and mood disorders may be common among pregnant women (Cripe et al, 2010; Williams et al, 2010). In a study of 2,293 pregnant women, 55.1% of migraineurs reported moderate to severe depressive symptoms during pregnancy compared to 36.7% of pregnant non-migraineurs (Cripe et al, 2010). Furthermore, migraineurs score higher on the Perceived Stress Scale (PSS) than non-migraineurs during the first trimester of pregnancy (mean ± SD: 4.2 ± 2.4 vs. 3.7 ± 2.3; p-value: 0.008) (Williams et al, 2010).…”