Cross-sectional study finds that developing depression before migraine links to greater disability, highlighting the clinical relevance of diagnostic trajectory.
Key Points
To investigate whether the diagnostic sequence of migraine and depression is associated with variations in physical, mental, and social health status.
Cross-sectional study of UK Biobank electronic health records (N = 327,234; 51.2% female, median age: 58 years).
Participants were categorized via ICD-10 codes into five groups: migraine-first (n = 2,036), depression-first (n = 1,217), migraine-only (n = 13,318), depression-only (n = 33,831), and healthy controls (n = 276,832) across data collected mostly between 2006 and 2010.
Patients diagnosed with depression before migraine had the highest odds of sleep problems (OR = 3.26, 95% CI: 2.72–3.92), high stress (OR = 3.68, 95% CI: 3.19–4.25), worst rated overall health (OR = 22.93, 95% CI: 17.72–29.68), neuroticism (β = 3.26, 95% CI: 3.09–3.44), and Townsend Deprivation Index (β = 0.76, 95% CI: 0.59–0.93; Bonferroni-corrected p < 0.001).
Both comorbid groups exhibited the highest body mass index (depression-first: β = 1.57, 95% CI: 1.31–1.83; migraine-first: β = 1.30, 95% CI: 1.09–1.50) and lowest physical activity levels (depression-first: OR = 0.55, 95% CI: 0.47–0.64; migraine-first: OR = 0.59, 95% CI: 0.53–0.67).