Cross‐prevalence of migraine and bipolar disorder

Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Bipolar Disorders (Impact Factor: 4.97). 06/2010; 12(4):397-403. DOI: 10.1111/j.1399-5618.2010.00832.x
Source: PubMed


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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    ABSTRACT: Background Previous research has suggested the clinical profile of individuals with bipolar disorder (BD) differs according to the presence or absence of comorbid migraine. We aimed to determine the clinical characteristics that differentiate individuals with BD with and without comorbid migraine in a large, representative, clinically well-characterised UK sample. Methods The lifetime clinical characteristics of 1488 individuals with BD (BPI n=1120, BPII n=368) with and without comorbid migraine were compared (n=375 vs. n=1113 respectively). Results Individuals with BD and comorbid migraine had a distinctive set of lifetime clinical characteristics. A multivariate model showed that consistent with previous studies those with comorbid migraine were significantly more likely to be female (OR=2.099, p=0.005) and have comorbid panic attacks (OR=1.842, p=0.004). A novel finding was that even after controlling for other differences, the individuals with BD and comorbid migraine were more likely to have a rapid cycling illness course (OR=1.888, p=0.002). Limitations Presence of migraine was assessed using self report measures. Cross-sectional study design limits investigations of bidirectional associations between migraine and bipolar disorder. Conclusions Comorbid migraine in BD may represent a more homogenous subtype of BD with an unstable rapid cycling course. Identifying individuals with BD and comorbid migraine may be of use in a clinical setting and this subgroup could be the focus of future aetiological studies.
    Journal of Affective Disorders 01/2015; 53. DOI:10.1016/j.jad.2015.01.024 · 3.38 Impact Factor
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    • "More often than noticed, bipolar disorder occurs together with migraine. In a study of patients suffering from bipolar disorder (both type I and II), Ortiz et al. [2] found comorbid migraine in 24.5% of all bipolar cases and McIntyre et al. [3] of 24.8% (versus a general population rate of 10.3%). Contrary to that, Holland et al. [4] found a much lower prevalence of 4.7%. "
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    ABSTRACT: This paper consists of a case history and an overview of the relationship, aetiology, and treatment of comorbid bipolar disorder migraine patients. A MEDLINE literature search was used. Terms for the search were bipolar disorder bipolar depression, mania, migraine, mood stabilizer. Bipolar disorder and migraine cooccur at a relatively high rate. Bipolar II patients seem to have a higher risk of comorbid migraine than bipolar I patients have. The literature on the common roots of migraine and bipolar disorder, including both genetic and neuropathological approaches, is broadly discussed. Moreover, bipolar disorder and migraine are often combined with a variety of other affective disorders, and, furthermore, behavioural factors also play a role in the origin and course of the diseases. Approach to treatment options is also difficult. Several papers point out possible remedies, for example, valproate, topiramate, which acts on both diseases, but no first-choice treatments have been agreed upon yet.
    Case Reports in Medicine 05/2012; 2012(2):389851. DOI:10.1155/2012/389851
    • "(fits and fainting) were also seen among female migraineurs. Previous clinical and community studies[17–24] have also reported a strong association between migraine and depression as well as anxiety disorders and also vice-versa.[2225] Migraine is more commonly associated with anxiety disorder than with depression.[517] "
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    ABSTRACT: Migraine is a common disorder which has psychiatric sequelae. The objective of this study was to determine the clinical pattern and psychiatric comorbidity of migraine. 100 cases of migraine seen over a period of one year were analysed to know the sociodemographic characteristics, clinical pattern and psychiatric morbidity. Maximum patients were between 31-40 years of age group (40%), females (78.0%), married (76%) and housewives (56.0%). Family history of migraine was present in 12% cases. Average age of onset was 22 years. Unilateral and throbbing type of headache was most common. The commonest frequency was one to two per week. Migraine without aura was commonest sub-type (80%). Generalized anxiety disorder (F41.1) was the most common psychiatric disorder (34%), followed by mixed anxiety and depressive disorder (F41.2) (18%) and depressive episode (F32) (14%). In 22% cases, no psychiatric disorder could be elicited. The present study confirms that majority patients with migraine had psychiatric disorders. This needs timely detection and appropriate intervention to treat and control the migraine effectively.
    Industrial psychiatry journal 03/2012; 21(1):18-21. DOI:10.4103/0972-6748.110943
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