Humanistic and Economic Burden of Depression and Anxiety among Adults with Migraine: A systematic review

Background: Depression and anxiety are highly prevalent disabling chronic conditions among adults with migraine. These comorbid conditions are becoming a well-recognized public health problem in many countries due to their humanistic and economic burden.Objectives This review was conducted to assess systematically the humanistic and financial burden of migraine and depression and/or anxiety disorder among adults with migraine.Methods A systematic literature search conducted using MedLine and CINAHL via EBSCO, OVID and Cochrane Database of Systematic Reviews via OVID. Studies evaluating the humanistic burden (disability and Health-related Quality of Life (HRQoL)) and the economic burden and healthcare utilization of comorbid depression and anxiety among adults with migraine that were published in peer-reviewed English language journals from inception until August 2019 were included.Results Of the 957 articles identified, 24 studies were included in the review. HRQoL was measured using generic, and migraine-specific measures. Regarding the humanistic burden, twelve studies reported an association between depression and/or anxiety and lower HRQoL and seven studies reported an association between depression and/or anxiety and higher disability. Regarding the economic burden, only two studies were identified and both found that depression and/or anxiety are associated with higher healthcare expenditures and utilization among adults with migraine.Conclusions These results of this review highlight the substantial impact of depression and/or anxiety on HRQoL, disability, healthcare cost and utilization of medical services for adults with migraine. It is important for healthcare providers to be aware of the negative impact of these illnesses and identify and treat anxiety and depression as treatment may have a potential to improve the health outcomes of patients living with migraine.