Page 34 - The clinical aspects and management of chronic migraine Judith Anne Pijpers

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Chapter 2
negative affect has often been indicated as a central clinical feature of both anxiety and depression, accounting for the high rates of comorbidity. The lack of positive affect covers anhedonic symptoms, which are mainly specific for depression.11-14 The somatic arousal dimension comprises symptoms of hyperarousal which are anxiety specific.
The aim of the present study is to investigate whether migraine patients are characterized by different symptom patterns of depressive and anxiety symptomatology compared with healthy controls, and persons with a current or past depression and/or anxiety disorder. Furthermore, we investigate which migraine specific characteristics are associated with the affective symptom dimensions of the tripartite model.
Methods
Study design and population
Four groups were differentiated for comparison: i) migraine patients, ii) healthy controls without psychopathology and without migraine, iii) persons with ‘current psychopathology’, a 6-month diagnosis of major depressive disorder, dysthymia or anxiety disorder and without migraine, and iv) persons with ‘past psychopathology’, a lifetime (but no current) diagnosis of major depressive disorder, dysthymia or anxiety disorder and without migraine.
Migraine patients were collected as a part of the Leiden University Medical Centre Migraine Neuro-analysis Programme (LUMINA) project, a well defined web-based migraine population, the details of which are reported elsewhere.15 The LUMINA project is an ongoing cohort study, designed to investigate migraine, its comorbidities, and its long-term course. Participants were Dutch adults aged 18 to 74 years with migraine with or without aura according to the International Classification of Headache Disorders (ICHD-III beta) criteria.16 The LUMINA study population recruitment is still ongoing, but we included participants recruited between 2008 and 2011. Participants were recruited via nationwide public announcement, advertising in lay press and via the research website, inviting migraine patients to participate in migraine research. In addition, patients attending our dedicated headache clinic were also invited to participate in this survey. This latter group, however, comprises only 3.5% of the total LUMINA population. On the website, patients were asked to fill out