OBJECTIVES: Depression and anxiety are often comorbid with migraine. Impact of depression and anxiety on work productivity has been well studied, however, the impact of comorbid depression and anxiety in migraine patients is not well understood. The objective of this real-world study was to examine the impact of co-morbid depression and/or anxiety on work productivity in adult migraine patients in the US.

METHODS: Data were drawn from the 2017 US Adelphi Migraine Disease Specific Programme, which included primary care physicians and neurologists and their consulting migraine patients. Patients completed a questionnaire that included work productivity and activity impairment (WPAI), and general quality of life using the EuroQol 5-dimension 5-level (EQ-5D-5L). Depression/anxiety was derived from the EQ-5D domain, and patients were categorized as experiencing none, slight, or moderate-to-severe (moderate+) depression/anxiety. Poisson regressions were run on WPAI overall and presenteeism (impairment in work) domains to assess the relationship between severity of anxiety/depression and headache days on work productivity outcomes. Logistic regression was run on WPAI absenteeism dichotomised yes/no variable.

RESULTS: 873 patients provided information on depression/anxiety. Activity impairment was assessed among all patients (n=801); work productivity was assessed among employed patients only (n=613). Worsening anxiety/depression and increasing number of headache days were associated with significantly greater overall activity and work impairment and presenteeism, as assessed by the WPAI (P<0.05). Worsening anxiety/depression and increasing numbers of headache days were not significantly associated with an increase in work time missed (P>0.05).

CONCLUSIONS: Migraine patients with depression/anxiety experience poorer overall work productivity and impairment at work that worsens with increasing number of headache days, although comorbid depression/anxiety in migraine patients is not associated with an increase in work time missed. These results suggest that, although migraine patients with comorbid depression/anxiety attend work, their performance is substantially impaired.