Why are migraineurs more depressed? A review of the factors contributing to the comorbidity of migraine and depression.

The comorbidity of migraine and depression is well-known. Patients with both conditions show stronger headache-related symptoms, a more severe clinical course and higher risk for migraine chronification. Therefore, it's important to identify factors underlying comorbid migraine and depression. The growing body of literature suggests complex, biopsychosocial mechanisms in the background, including shared genetic risk factors and abnormal brain mechanisms, and also different environmental (stress) and psychological variables (for example: rumination, neuroticism). In this short review we summarize the most important findings regarding the interacting factors in the pathomechanism of the co-existence of migraine and depression. Finally, we conclude some therapeutical considerations regarding treatment of patients with the migraine-depression phenotype.