Cross‐prevalence of migraine and bipolar disorder
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. "
ABSTRACT: 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.Journal of Affective Disorders 01/2015; 53. DOI:10.1016/j.jad.2015.01.024 · 3.71 Impact Factor
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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). "
ABSTRACT: Patients treated with antipsychotic drugs often receive concomitant psychotropic compounds. Few studies address this issue from a lifetime perspective. Here, an analysis is presented of the prescription pattern of such concomitant medication from the first contact with psychiatry until the last written note in the case history documents, in patients with a diagnosis of psychotic illness. A retrospective descriptive analysis of all case history data of 66 patients diagnosed with schizophrenia or schizophrenia-like psychotic disorders. Benzodiazepines and benzodiazepine-related anxiolytic drugs had been prescribed to 95% of the patients, other anxiolytics, sedatives or hypnotic drugs to 61%, anti-parkinsonism drugs to 86%, and antidepressants to 56% of the patients. However, lifetime doses were small and most of the time patients had no concomitant medication. The prescribed lifetime dose of anti-parkinsonism drugs was associated with that of prescribed first-generation but not second-generation antipsychotics. Most psychosis patients are sometimes treated with concomitant drugs but mainly over short periods. Lifetime concomitant add-on medication at the individual patient level is variable and complex but not extensive. Copyright © 2011 John Wiley & Sons, Ltd.Human Psychopharmacology Clinical and Experimental 06/2011; 26(4-5):322-31. DOI:10.1002/hup.1209 · 1.85 Impact Factor
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ABSTRACT: BACKGROUND: Bipolar disorder (BD) has been associated with high rates of general medical comorbidities (GMC) and medical risk factors. There have been scarce reports about this prevalence in Brazilian subjects with BD. OBJECTIVE: Describe the prevalence of GMC in a sample of BD type I patients. METHODS: Clinical records of 195 patients with BD type I were reviewed for identification of GMC. Patients with and without GMC were compared using the Mann-Whitney nonparametric test and the chi-Square test. RESULTS: Sixty-three percent of patients had at least one medical comorbidity. The most prevalent conditions were: migraine (31.8%), hypothyroidism (24.1%), hypertension (11.3%), traumatic brain injuries (10.3%), asthma (9.7%), epilepsy (8.2%), diabetes (5.1%), stroke (2.1%) and hyperthyroidism (1%). Age and duration of illness were positively associated with the presence of GMC (p < 0.001). DISCUSSION: In our study, in accordance with previous reports, the majority of patients presented at least one general medical disorder. The principal limitation of this study is the fact that diagnose of GMC was made based on self-report. There are scarce studies addressing GMC in the Brazilian population with BD and this report can contribute to improve diagnostic vigilance, assessment, treatment planning and decrease the burden associated with BD.Revista de Psiquiatria Clínica 12/2010; 38(6):227-230. DOI:10.1590/S0101-60832011000600003 · 0.89 Impact Factor