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Maternal and child mental health and incident migraine in adolescence: An All Our Families prospective cohort study
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DOI：10.1111/head.70078.png)
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Abstract
En 中文
Objective: To examine the association between mental health symptoms in youth and their mothers, and youth incident migraine, using prospectively collected, longitudinal data from the All Our Families (AOF) cohort study. Background: Internalizing mental health symptoms, such as anxiety and depression, whether experienced by a child or his/her parent(s), have been linked to migraine and chronic pain conditions, but causal inferences have been limited by gaps in the current literature. We hypothesized a priori that elevated youth and/or maternal internalizing symptoms across childhood would be associated with elevated odds of incident migraine in early adolescence, providing insights into the modifiable mental health contributors to incident migraine. Methods: A community-recruited sample of urban youth (N = 1062, 48% female) living in Alberta, Canada were followed through the AOF prospective cohort study from 2008 to 2023. The study outcome, youth migraine, was ascertained through a validated migraine diagnostic questionnaire, administered to 12-year-old youth. The exposures of interest, anxiety and depressive symptoms in youth and mothers, were derived from multiple timepoints when these symptoms were measured, across youth ages 4-12 years. The analysis compared odds of incident migraine in youth with a history of elevated internalizing symptoms, and/or exposure to elevated maternal symptoms, versus unexposed youth. Covariates accounted for included age, sex, gender and racial identity, household income, and parental migraine status. Results: The odds of incident migraine, diagnosed at a mean age of 12.9 years (standard deviation [SD] 0.8 years) were increased by similar to 29% with each additional timepoint when maternal anxiety symptoms were elevated across childhood (adjusted odds ratio [aOR] 1.29 per exposure, 95% confidence interval [CI] 1.02-1.64, p = 0.036). Similarly, the odds of incident migraine increased by similar to 29% with each additional exposure to significant youth depressive symptoms across childhood (aOR 1.29 per exposure, 95% CI 1.03-1.61, p = 0.026). Sex did not modify this association. Conclusion: Findings suggest that maternal anxiety and youth depressive symptoms have an antecedent role in youth migraine risk. Although certain migraine risk factors remain non-modifiable (e.g., genetic inheritance), child and parent mental health symptoms may be alleviated through evidence-based mental health treatments. Future clinical research should explore whether reducing exposure to child and parent mental health symptoms could prevent or delay the development of new migraine cases (incident migraine).
Keywords:
anxiety
depression
incidence study
internalizing
mental health
migraine etiology
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