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Migren Hastalarında Anksiyete, Depresyon ve Obsesif-Kompulsif Belirti Düzeyleri

Amaç: Migren hastalarında anksiyete ve depresyon gibi çeşitli psikiyatrik belirtiler genel toplumdan daha sık görülmektedir. Bu belirtilerin tespiti, tedavinin başarısı açısından önemlidir. Çalışmamızın amacını migren ile normal bireyler ve auralı migren ile aurasız migrenliler arasında anksiyete, depresyon ve obsesif-kompulsif bozukluk belirti düzeylerinin karşılaştırılması ve bu düzeylerin hastalık süresi ve atak sıklığı ile ilişkisinin incelenmesi olarak belirledik. Gereç ve Yöntem: Çalışmamıza hastanemizin nöroloji polikliniğine ardı sıra başvuran ve Uluslararası Baş Ağrısı Topluluğu’nun (International Headache Society-IHS) 2004 tanı ölçütlerine göre tanısı konulan 66 erkek migren hastası (13 auralı, 53 aurasız) ve bu hastalarla benzer yaş ve eğitim düzeyine sahip 32 erkek sağlıklı kontrol grubu dâhil edildi. Her iki gruba psikolog tarafından Beck Anksiyete Ölçeği (BAÖ), Beck Depresyon Ölçeği (BDÖ) ve Maudsley Obsesif Kompulsif Soru Listesi (MOKSL) uygulandı. Migren grubunda atak sıklığı; ayda 4 ve altında atak geçirenler seyrek, 5 ve üzerinde atak geçirenler sık olarak belirlendi. Migren ile kontrol grubu ve auralı migren ile aurasız migrenliler arasında ölçek sonuçları birbirleri ile karşılaştırıldı ve migren grubunda skorların hastalık süresi ve atak sıklığı ile ilişkisi incelendi. Bulgular: Anksiyete düzeyleri migren grubunda kontrol grubuna göre yüksek olsa da istatistiksel olarak anlamlı değildi. Gruplar arasında MOKSL düzeyleri açısından istatistiksel anlamlılık bulunmazken, depresif belirti düzeyleri migren grubunda anlamlı olarak yüksek bulundu. Hastalık süresi ile depresif belirti düzeyleri arasında anlamlı ilişki saptanmazken, migren atakları sık olanlarda (ayda 5 ve üzeri) depresif belirti düzeyleri daha yüksek saptandı. Auralı ve aurasız migrenlilerin tüm test sonuçları benzerdi. Migren atak sıklığı sık ve seyrek olanların BAÖ ve MOKSL düzeyleri açısından farklılık yoktu. Depresif belirti ile anksiyete düzeyleri arasında pozitif yönde güçlü ve istatistiksel olarak anlamlı bir ilişki saptanmıştır. Sonuç: Depresif belirti düzeyleri migren hastalarında yüksektir ve migren atakları sık olanlarda artmaktadır. Migrenlilerde depresif belirti düzeyleri hastalık süresi ile ilişkisiz olup anksiyete düzeyleri ile pozitif ilişkilidir. Migren hastalarında anksiyete ve depresif belirtilerin sorgulanması ve tedavi edilmesi önemlidir.

Anahtar Kelimeler:

migren, anksiyete, depresyon, obsesif-kompulsif belirtiler

The levels of anxiety, depression and obsessive-compulsive symptoms in migraine patients

Objective: Psychiatric symptoms, such as anxiety and depression, are seen more in migraine patients than general population. Establishing of these symptoms is important in terms of successful management. The aim of our study is to compare the levels of anxiety, depression and obsessive-compulsive disorder symptoms between migraine patients and normal population and between migraine with aura and migraine without aura and to detect the relationship of the levels of these disorders with duration of disease and frequency of the attacks . Method: We included 66 male migraine patients (13 with aura; 53 without aura) diagnosed according to the diagnostic criteria of The International Headache Society-2004 (IHS 2004) in our neurology outpatient clinic and 32 healthy males with similar age and education level. Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Maudsley Obsessive-Compulsive Question List (MOCQL) had been applied to both groups by a psychologist. The frequency of the attacks in migraine group was accepted as rare if it was less than 4 in a month and frequent if it was more than 5 in a month. The inventory results of migraine patients vs. normal population and migraine with aura vs. migraine without aura had been compared and the relationship of the scores with the duration of the disease and the frequency of the attacks had been examined. Results: The scores of anxiety were higher but statistically insignificant in migraine group. The scores of MOCQL were statistically insignificant between the groups, but depression was found to be significantly higher in the migraine group. There was no significant correlation between the duration of the disease and depression, whereas patients with frequent attacks (more than 5 in a month) had higher levels of depressive symptoms. All test scores of migraine with aura and migraine without aura are similar. There was no difference in terms of BAI and MOCQL between patients having frequent attacks and rare attacks. Depression and anxiety levels were significantly related to each other in a strong positive way. Conclusion: Levels of depressive symptoms is high in migraine patients and its frequency increases as the frequency of the attacks increase. There is no relationship between levels of depressive symptoms and disease duration in migraine patients; whereas levels of depression symptoms and anxiety levels has a positive relation. It is important to examine and treat the anxiety and depressive symptoms in migraine patients.

Keywords:

migraine, anxiety, depression, obsessive compulsive symptoms,

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