Article

Cross‐prevalence of migraine and bipolar disorder

Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Bipolar Disorders (Impact Factor: 4.89). 06/2010; 12(4):397-403. DOI: 10.1111/j.1399-5618.2010.00832.x
Source: PubMed

ABSTRACT In two related studies, we explored the prevalence of migraine and its associated clinical characteristics in patients with bipolar disorder (BD) as well as psychiatric morbidity in patients treated for migraine.
The first study included 323 subjects with BD type I (BD I) or BD type II (BD II), diagnosed using the Schedule for Affective Disorders and Schizophrenia, Lifetime version (SADS-L) format, or the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). Migraine history was assessed by means of a structured questionnaire. In a second sample of 102 migraine patients, we investigated current and lifetime psychiatric morbidity using the SADS-L. Statistical analyses were conducted using nonparametric analysis and log-linear models.
A total of 24.5% of BD patients had comorbid migraine; those with BD II had a higher prevalence (34.8%) compared to BD I (19.1%) (p < 0.005). BD patients with comorbid migraine had significantly higher rates of suicidal behaviour, social phobia, panic disorder, generalized anxiety disorder, and obsessive-compulsive disorder (all p < 0.05). In the sample of migraine patients, 34.3% had a current psychiatric diagnosis, and 73.5% had a lifetime psychiatric diagnosis. The prevalence of BD I was 4.9%, and 7.8% for BD II.
Migraine is prevalent within the BD population, particularly among BD II subjects. It is associated with an increased risk of suicidal behaviour and comorbid anxiety disorders. Conversely, migraine sufferers have high rates of current and lifetime psychopathology. A greater understanding of this comorbidity may contribute to our knowledge of the underlying mechanisms of BD.

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    • "Previous studies have shown that individuals with comorbid BD and migraine have different clinical characteristics to individuals with BD without migraine. Earlier age of onset of BD (Mahmood et al., 1999; McIntyre et al., 2006), increased prevalence of comorbid panic disorders (Fasmer and Oedegaard, 2001; Ortiz et al., 2010), higher prevalence of bipolar II disorder subtype (Fasmer and Oedegaard, 2001; Ortiz et al., 2010) and higher rate of attempted suicide (Ortiz et al., 2010) have all been associated with BD with comorbid migraine. These differences support the proposal that the presence of comorbid migraine represents a more homogenous subtype of BD. "
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    • "Increased prevalence of migraine among persons with psychiatric diagnoses has been reported by many studies (Low et al., 2003; McIntyre et al., 2006; Ortiz et al., 2010). Common psychiatric comorbidity among migraine sufferers has also been reported (Breslau and Davis, 1993; Merikangas and Stevens, 1997; Ortiz et al., 2010). Imbalance in serotonin (5‐HT) neurotransmission is one of the possible factors linking pathophysiology of migraine (Hamel, 2007) with other disorders such as depression, anxiety, epilepsy and schizophrenia (Hedlund, 2009; Pytliak et al., 2011). "
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