The results of this study indicated a higher incidence of depressive symptoms, headache intensity, and more likely to have a severe headache-related disability in migraine patients with and without fibromyalgia.

Fibromyalgia is a commonly characterized pain condition indicated by widespread chronic pain, fatigue, sleep disturbances, headache, impaired cognition, anxiety and mood disorders with unknown aetiology. It is more prevalent in females as compared to males. Previous research has reported an association between comorbid fibromyalgia and migraine, that ranges from 18% to 35.6%. It was investigated that central sensitization plays an integral role in fibromyalgia and chronic migraine. These two disorders are thus considered debilitating pain disorders that increases morbidity of other diseases and affects the quality of life in patients if present together.

Rationale behind research

• The previous studies don't indicate an association between the incidence of depressive symptoms in patients with a migraine as well as comorbid fibromyalgia. It is the first study that has determined various depression symptoms, headache intensity in patients with a migraine and fibromyalgia.

Objective

The present study aims at determining differences in depressive symptoms, headache intensity and migraine-related disability in patients with comorbid fibromyalgia and migraine compared to age and sex matched controls with a migraine only.

Study outcomes

• Baseline: The characteristics studied at baseline were BMI, number of headache days in the four weeks preceding the initial visit, the age of onset of headaches, number of subjects with 15 or more headache days in the last four weeks, and average duration of migraines
• The Primary outcomes studied were depressive symptoms assessed by PHQ-9, the intensity of a headache, and migraine-related disability evaluated by MIDAS

Time Points: Baseline and after four weeks 

Outcomes

Baseline: There were no significant differences observed at baseline. 

Study outcomes:

• There were significantly higher PHQ-9 scores (OR 1.08, p < .0001) and headache intensity scores (OR 1.149, p = .007) reported in patients with comorbid fibromyalgia, but there was no significant difference in migraine-related disability (OR 1.002, p = .075) (Fig.1)
• There was an incidence of higher scores in depression severity (OR 1.467, p < .0001) and migraine-related disability (OR 1.23, p = .004) in patients with fibromyalgia (Fig.1)

The results of the present retrospective study indicate a higher prevalence of fibromyalgia in migraine patients and vice-versa. Higher PHQ-9 and average headache intensity scores were observed in patients with comorbid fibromyalgia. The patients were more likely to score in a higher severity category for both the MIDAS and the PHQ-9. The present study justifies the previous reports of increased headache-related disability, depression, and headache severity in patients with comorbid fibromyalgia and migraine as compared to those with a migraine only. The incidence of fibromyalgia in patients with migraine was correlated with impaired quality of life. The findings of the study indicate the need for inquiring about comorbid fibromyalgia as this can be helpful in creating an optimal individualized treatment plan. The investigation determined that it is essential to screen for symptoms of fibromyalgia in migraine patients when many depressive symptoms, severe headache intensity, or severe headache-related disability were encountered.