Migraines linked to childhood anxiety.

Migraines linked to childhood anxiety

About 20 percent of migraine sufferers endure a triple whammy of disorders as they age, according to a new long-term study. During childhood, excessive worrying and other anxiety symptoms appear; by early adolescence, migraine headaches begin; and bouts of severe depression kick in after another three or four years.

This evolving pattern represents a distinct syndrome, or group of related symptoms, reports a team led by psychiatrist Kathleen R. Merikangas of Yale University School of Medicine. Anxiety apparently does not cause the migraines, and the migraines do not cause the depression, the researchers point out.

However, shared neurochemical mechanisms may lie at the heart of the anxiety-migraine-depression triad, they maintain. For example, recent investigations revealed that migraine headaches sometimes respond to antidepressants, and that reserpine -- a drug that depletes dopamine and other chemical messengers in the brain -- elicits both depression and migraines in some people.

But until now, researchers lacked evidence of a strong relationship between migraines and anxiety, and thus did not seek physiological links between the two, Merikangas and her co-workers note in the September ARCHIVES OF GENERAL PSYCHIATRY. Moreover, previous reports of an association between depression and migraines -- which led to speculation that depression may lead to migraines -- were based on single assessments of migraine patients who sought medical treatment.

Merikangas' team recruited 457 people living in Zurich, Switzerland. The sample was not completely random, since two-thirds of the volunteers were selected based on elevated scores on a checklist of psychiatric symptoms. Researchers interviewed participants in 1978, 1981 and 1986, and had them fill out questionnaires on headaches and psychiatric symptoms twice a year. By the third interview, participants were 27 to 28 years old.

About 13 percent had at some time experienced common migraine headaches (without preceding visual or neurological sensations known as auras). Migraines occurred substantially more often in women and in participants with elevated psychiatric symptom scores, the researchers found.

Retrospective self-reports showed that, for about one in five migraine sufferers, excessive anxiety and fears of public situations emerged at about age 12, followed by the onset of migraines at age 14 and severe depression at age 17 to 18.

The investigators plan to chart the psychiatric course of the Zurich migraine sufferers as they proceed through adulthood.