The Medical Costs of Migraine and Comorbid Anxiety and Depression
- 4 June 2004
- journal article
- research article
- Published by Wiley in Headache: The Journal of Head and Face Pain
- Vol. 44 (6), 562-570
- https://doi.org/10.1111/j.1526-4610.2004.446004.x
Abstract
To examine the direct medical costs associated with migraine, when diagnosed alone and in conjunction with anxiety and/or depression in adults and children. Migraine is a common disorder that can often be accompanied by comorbid anxiety and/or depression. Given the prevalence of migraine and the likelihood for comorbid conditions, it is not surprising that migraine is extremely costly for society. Migraine cohorts were identified in a 1999-2000 database capturing inpatient, outpatient, and prescription drug services from approximately 45 large employers. Four cohorts of adults (migraine only, migraine and anxiety, migraine and depression, migraine and both conditions), and two cohorts of children (migraine only, migraine and anxiety and/or depression), were compared to respective "healthy" cohorts. t-statistics were used to capture differences in costs between the migraine cohorts and the healthy cohorts whereas ANOVA was used to test for differences in costs between subgroups of migraine sufferers. Compared to nonmigraineurs, adults and children with migraine had significantly higher total direct medical costs in all examined categories (P < .0001) (7,089 US Dollars vs US Dollars adults; 4,272 US Dollars vs 1,400 US Dollars children). For adults, the presence of depression and/or anxiety along with migraine equated to significantly greater total direct medical costs when compared to their matched healthy cohorts (P < .0001) (12,642 US Dollars vs 5,179 US Dollars anxiety; 11,290 US Dollars vs 3,135 US Dollars depression). Children with migraine and either anxiety or depression (or both) incurred an average of 9,875 US Dollars in total direct medical costs as compared with only 1,165 US Dollars for healthy comparators. For children and adults, the presence of comorbid anxiety or depression was associated with significantly higher medical costs when compared to migraine alone (P < .0001). This analysis quantifies the economic impact of a migraine diagnosis for both adults and children. The results of this analysis demonstrate that individuals identified as migraineurs have significantly higher medical costs than healthy comparators, with or without comorbid anxiety and/or depression. This study also suggests that clinicians should be aware that while proper treatment of migraine with effective acute and prophylactic therapy is important, attention must also be directed to comorbid conditions.Keywords
This publication has 34 references indexed in Scilit:
- Diagnoses and Symptom Patterns in Children Presenting to a Pediatric Headache ClinicHeadache: The Journal of Head and Face Pain, 1993
- Migraine, physical health and psychiatric disorder: A prospective epidemiologic study in young adultsJournal of Psychiatric Research, 1993
- Impact of Migraine in the United States: Data from the National Health Interview SurveyHeadache: The Journal of Head and Face Pain, 1993
- EPIDEMIOLOGY OF HEADACHE AND CHILDHOOD MIGRAINE IN AN URBAN GENERAL PRACTICE USING AD HOC, VAHLQUIST AND IHS CRITERIADevelopmental Medicine and Child Neurology, 1992
- Depression in Adolescent Headache PatientsHeadache: The Journal of Head and Face Pain, 1992
- Healthcare Resource and Lost Labour Costs of Migraine Headache in the USPharmacoEconomics, 1992
- Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factorsJAMA, 1992
- PREVALENCE OF MIGRAINE AND OTHER HEADACHE IN FINNISH CHILDREN STARTING SCHOOLHeadache: The Journal of Head and Face Pain, 1976
- EVALUATION OF THE RELATIONSHIP BETWEEN MIGRAINE HEADACHE AND DEPRESSIONHeadache: The Journal of Head and Face Pain, 1975
- Migraine in School ChildrenActa Paediatrica, 1962