Migraine and Psychiatric Comorbidity among Arabs Living in Different Societal Environments

Abstract

Background: The prevalence of migraine and psychiatric comorbidities has been found to differ on a global scale according to country development. We aimed to determine this prevalence in three samples of Arabs living in different countries at different levels of development and political stability. Methods: The study included Saudi and Syrian participants ≥16 years of age. The cohort was subdivided into three groups: Saudi Arabian residents (SARs), Syrian residents (SRs), and Syrian expatriates (SEs). Information regarding age, sex, education, and marital status was also collected. Migraine was determined by the International Classification of Headache Disorders-3 criteria; depression and bipolar disorder were determined by the Patient Health Questionnaire-9 and the Mini-International Neuropsychiatric Interview, respectively. Odds ratios were estimated for associations. Results: Of 620 participants, 102 (16.5%) met migraine criteria, and 81 (79.4%) were female. Migraine was found in 66 (20.6%) SARs, 25 (19%) SEs, and 11 (6.5%) SRs. Being married was significantly associated with migraine (P = 0.01). Depression had a significant association with migraine within the entire cohort (odds ratio [OR] =2, confidence interval [CI] =1.2–3.1, P = 0.004) and the subgroups of SEs (OR =3, CI =1.14–7.8, P = 0.02) and SARs (OR =2.1, CI =1.14–7.8, P = 0.02); depression was significantly associated in the SE and SAR migraine groups (both P = 0.02). Conclusion: Migraine and comorbid depression occur at a rate similar to international reports in Middle Eastern Arabs and more prominently in SEs and SARs. The migraine frequency was lower in SRs in comparison to SEs and SARs residing in more developed countries. Future research that explores these conditions under different environmental and sociopolitical circumstances will improve the understanding of causal relationships.