Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications

• Published in: Journal of headache and pain Vol. 20; no. 1; pp. 51 - 17
• Main Authors: Dresler, Thomas, Caratozzolo, Salvatore, Guldolf, Kaat, Huhn, Jana-Isabel, Loiacono, Carmela, Niiberg-Pikksööt, Triinu, Puma, Marta, Sforza, Giorgia, Tobia, Anna, Ornello, Raffaele, Serafini, Gianluca
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 09.05.2019; Springer Nature B.V; BMC
• Subjects: Anxiety; Biological pathways; Comorbidity; Databases, Factual - trends; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - psychology; Depressive Disorder, Major - therapy; Disabled Persons - psychology; Evidence-based medicine; Female; Headache; Hot topics in headache and pain from the EHF-SAS; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Mental depression; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - therapy; Migraine; Migraine Disorders - epidemiology; Migraine Disorders - psychology; Migraine Disorders - therapy; Neurology; Pain Medicine; Prevalence; Psychiatric disorders; Review; Review Article; Reviews; Systematic review; Treatment Outcome; Biological pathways; Comorbidity; Psychiatric disorders; Migraine
• ISSN: 1129-2369; 1129-2377; 1129-2377
• DOI: 10.1186/s10194-019-0988-x

Background Migraine is a highly prevalent and disabling neurological disorder which is commonly linked with a broad range of psychiatric comorbidities, especially among subjects with migraine with aura or chronic migraine. Defining the exact nature of the association between migraine and psychiatric disorders and bringing out the pathophysiological mechanisms underlying the comorbidity with psychiatric conditions are relevant issues in the clinical practice. Methods A systematic review of the most relevant studies about migraine and psychiatric comorbidity was performed using “PubMed”, “Scopus”, and “ScienceDirect” electronic databases from 1 January 1998 to 15 July 2018. Overall, 178 studies met our inclusion criteria and were included in the current review. Results According to the most relevant findings of our overview, the associations with psychiatric comorbidities are complex, with a bidirectional association of major depression and panic disorder with migraine. Importantly, optimizing the pharmacological and non-pharmacological treatment of either migraine or its psychiatric comorbidities might help clinicians to attenuate the burden of both these conditions. Conclusions The available data highlight the need for a comprehensive evaluation of psychiatric disorders in migraine in order to promote an integrated model of care and carefully address the burden and psychosocial impairment related to psychiatric comorbidities in migraine.