Page 36 - The clinical aspects and management of chronic migraine Judith Anne Pijpers

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Chapter 2
The CIDI is a standardized psychiatric diagnostic interview that follows the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria to establish diagnoses. The CIDI is a highly reliable and valid instrument for assessing depressive and anxiety disorders20 and was administered by specially trained research staff. Psychopathology (major depressive disorder, dysthymia, anxiety disorder) status was categorized as follows: current diagnosis (i.e., past 6 months), past diagnosis (i.e., lifetime diagnosis but not in the past 6 months), controls (no lifetime diagnosis). In both the LUMINA and NESDA studies, a 30-item adaptation of the Mood and Anxiety Symptoms Questionnaire (MASQ-D30) was used to measure the tripartite dimensions of depression. On the MASQ-D30, participants were asked to rate to what extent in the past week they had experienced ‘feelings, sensations, problems and experiences that people sometimes have’ on a 5-point scale, with 1 being ‘not at all’ and 5 being ‘extremely’. The three 10-item subscales are ‘general distress’ (lack of positive affect), ‘anhedonic depression’ (negative affect) and ‘anxious arousal’ (somatic arousal). The MASQ-D30 scales showed adequate psychometric characteristics and showed good reliability and validity within the NESDA study.21
In the LUMINA population, we predefined migraine specific characteristics to be examined: migraine subtype (migraine with or without aura), frequency (migraine days per year), and cutaneous allodynia. Cutaneous allodynia, the perception of pain in response to non-noxious stimuli to the normal skin, is a common feature accompanying migraine attacks. A significant part of migraine patients experience an increased sensitivity of the skin for common daily activities during attacks, such as combing of hair, taking a shower, touching the periorbital skin, shaving, or wearing earrings during migraine attacks. Cutaneous allodynia was measured using a validated questionnaire.22 These migraine specific characteristics are shown to be associated with depression.23;24
Data analysis and statistics
Baseline characteristics were reported as mean ± standard deviations (SD) or percentages. Analysis of covariance (ANCOVA) models were used to test the association between the four different groups and MASQ-D30 symptom profiles, adjusting for gender and age. Post-hoc analyses were run in case of significant findings, performing ANCOVA analysis to test for differences between the migraine group and the three remaining groups. Results were presented as p-values with Cohen’s d (the difference between the means, divided by the pooled standard deviation) as a measure of effect size. Secondary