Anxiety and Depression in Children and Adolescents With Migraine: Serena L. Orr, MD, MSc

The pediatric neurologist and headache specialist at the University of Calgary discussed the work she presented at AHS 2022 on the incidence of anxiety and depressive disorders in the pediatric migraine population. [WATCH TIME: 6 minutes]

WATCH TIME: 6 minutes

“What we found is that children and adolescents with migraine have a much higher burden of anxiety symptoms. When we looked at that at the meta-analysis level, the effect size was very large, and there was also a doubling of the odds of having an anxiety disorder in this population compared to healthy controls. [We saw] similar findings for depressive symptoms.”

For some time, it has been assumed that pediatric patients with migraine have a higher risk for anxiety and depression, though little hard evidence existed to confirm this clinical suspicion. Although, recently, a systematic review and meta-analyses were conducted that showed that children and adolescents with migraine were in fact at higher risk for anxiety and depressive symptoms—with moderate to large effect sizes—and, notably, had almost double the odds of having these disorders compared with those without migraine.

The group screened 4277 studies, ultimately including 79, of which 73 reported on the association between the exposures and migraine, and 51 were amenable to quantitative pooling. There was a large association between migraine and anxiety symptoms when assessing data from 16 of the studies (standardized mean difference, 1.13; 95% CI, 0.64-1.63; P <.0001) and a moderate association between migraine and depressive symptoms when assessing data from 17 of the studies (standardized mean difference, 0.67; 95% CI, 0.46-0.87; P <.0001).

These data were presented at the 2022 American Headache Society (AHS) Annual Scientific Meeting, June 9-11, in Denver, Colorado, by Serena L. Orr, MD, MSc, pediatric neurologist, and headache specialist, University of Calgary. She explained to NeurologyLive® in a conversation at the meeting that these results open the door for additional work to be done to help address this challenge for patients. Importantly, she said, they highlight the need for physicians to screen these patients for anxiety and depressive symptoms in their routine care.

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1. Orr SL, Fall K, Kuziek J, Mahnaz SR, Noel M, Ronksley PE. OR-19: Anxiety and Depressive Symptoms and Disorders in Children and Adolescents with Migraine: A Systematic Review and Meta-Analysis. Presented at: AHS Annual Scientific Meeting; June 9-11, 2022; Denver, CO. OR-19