Migraine linked to depression, stress in sub-Saharan Africans

By Piriya Mahendra, medwireNews Reporter

Migraine is significantly associated with stress and unipolar psychiatric symptoms in sub-Saharan African adults, researchers say.

Moreover, although migraine prevalence has previously been reported to be higher in Caucasians than African Americans, Bizu Gelaye (Harvard School of Public Health, Boston, Massachusetts, USA) and team's study shows a high migraine prevalence among urban-dwelling Ethiopian adults (9.9%). This figure is comparable to what is typically reported in predominantly Caucasian cohorts, they remark.

The cross-sectional epidemiologic study evaluated 2151 employed adults in sub-Saharan Africa. A total of 9.8% (n=212) of participants fulfilled the International Classification of Headache Disorders-2 criteria for migraine, with a higher frequency among women (14.3%) than men (6.9%).

Sub-Saharan African individuals with migraine were significantly more likely than those without migraine to be young (18-29 years), less educated (high school level or lower), and to report poor health status. This set of demographics is similar to that seen in predominantly Caucasian cohorts, say the authors.

However, in contrast to Caucasian individuals in previous studies, sub-Saharan individuals with migraine were less likely to report smoking than those without migraine.

Participants with moderately severe depressive symptoms (score of ≥15 on the Patient Health Questionnaire-9) had a 3.36-fold higher risk for migraine than those with minimal or no depressive symptoms (score <4). The risk for migraine significantly increased with rising severity of depressive symptoms.

Individuals with mild anxiety (defined as a score of 8-9 on the Depression Anxiety Stress Scales), as well as those with moderate (10-14) and severe (≥15) anxiety had a 2.28-, 1.77-, and 5.39-fold increased risk for migraine, respectively, compared with individuals without anxiety (<7). Individuals with severe stress (defined as ≥26 on the Depression Anxiety Stress Scales) had a 3.57-fold increased risk for migraine, compared with those with no stress (0-14).

The authors conclude: "The high burden of migraine and its association with stress and unipolar psychiatric symptoms in our study of well-educated and urban dwelling African adults has important clinical and public health implications pending confirmation in other African populations."

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