Migraine and psychiatric comorbidity: a review of clinical findings

Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric ill...

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Published inJournal of headache and pain Vol. 12; no. 2; pp. 115 - 125
Main Authors Antonaci, Fabio, Nappi, Giuseppe, Galli, Federica, Manzoni, Gian Camillo, Calabresi, Paolo, Costa, Alfredo
Format Journal Article
LanguageEnglish
Published Milan Springer Milan 01.04.2011
Springer Nature B.V
Subjects
Adult
Anxiety
Bipolar disorder
Child
Children
Classification
Comorbidity - trends
Depressive Disorder - epidemiology
Depressive Disorder - physiopathology
Drug abuse
Evolution
Headache
Humans
Internal Medicine
Medicine
Medicine & Public Health
Mental disorders
Meta-analysis
Migraine
Migraine Disorders - diagnosis
Migraine Disorders - epidemiology
Migraine Disorders - psychology
Neurological diseases
Neurology
Pain
Pain Medicine
Population studies
Review
Review Article
Reviews
Depression
Comorbidity
Psychiatric disorders
Migraine
Meta-analysis
Online AccessGet full text
ISSN1129-2369
1129-2377
1129-2377
DOI10.1007/s10194-010-0282-4

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Abstract Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.
AbstractList Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.
Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.[PUBLICATION ABSTRACT]
Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.
Author Antonaci, Fabio
Calabresi, Paolo
Costa, Alfredo
Nappi, Giuseppe
Manzoni, Gian Camillo
Galli, Federica
Author_xml – sequence: 1
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  surname: Antonaci
  fullname: Antonaci, Fabio
  email: fabio.antonaci@unipv.it
  organization: University Centre for Adaptive Disorders and Head pain (UCADH), Headache Medicine Centre, Policlinic of Monza, University Consortium for Adaptive Disorders and Head pain (UCADH)
– sequence: 2
  givenname: Giuseppe
  surname: Nappi
  fullname: Nappi, Giuseppe
  organization: University Centre for Adaptive Disorders and Head pain (UCADH)
– sequence: 3
  givenname: Federica
  surname: Galli
  fullname: Galli, Federica
  organization: Department of Child and Adolescent Neuropsychiatry, University La Sapienza
– sequence: 4
  givenname: Gian Camillo
  surname: Manzoni
  fullname: Manzoni, Gian Camillo
  organization: Department of Neuroscience, Headache Centre, University of Parma
– sequence: 5
  givenname: Paolo
  surname: Calabresi
  fullname: Calabresi, Paolo
  organization: Neurology Clinic, S. Maria della Misericordia Hospital, University of Perugia
– sequence: 6
  givenname: Alfredo
  surname: Costa
  fullname: Costa, Alfredo
  organization: University Centre for Adaptive Disorders and Head pain (UCADH), National Institute of Neurology IRCCS C, Mondino Foundation Pavia
BackLink https://www.ncbi.nlm.nih.gov/pubmed/21210177$$D View this record in MEDLINE/PubMed
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Keywords Depression
Comorbidity
Psychiatric disorders
Migraine
Meta-analysis
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Snippet Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex....
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StartPage 115
SubjectTerms Adult
Anxiety
Bipolar disorder
Child
Children
Classification
Comorbidity - trends
Depressive Disorder - epidemiology
Depressive Disorder - physiopathology
Drug abuse
Evolution
Headache
Humans
Internal Medicine
Medicine
Medicine & Public Health
Mental disorders
Meta-analysis
Migraine
Migraine Disorders - diagnosis
Migraine Disorders - epidemiology
Migraine Disorders - psychology
Neurological diseases
Neurology
Pain
Pain Medicine
Population studies
Review
Review Article
Reviews
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Title Migraine and psychiatric comorbidity: a review of clinical findings
URI https://link.springer.com/article/10.1007/s10194-010-0282-4
https://www.ncbi.nlm.nih.gov/pubmed/21210177
https://www.proquest.com/docview/860887670
https://www.proquest.com/docview/1093471418
https://www.proquest.com/docview/861202989
https://pubmed.ncbi.nlm.nih.gov/PMC3072482
Volume 12
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