Migraine and psychiatric comorbidity: a review of clinical findings

The Journal of Headache and Pain

Review Article

Federica Galli¹  Gian Camillo Manzoni²  Paolo Calabresi³  Giuseppe Nappi⁴  Fabio Antonaci⁵  Alfredo Costa⁶ 

[1] Department of Child and Adolescent Neuropsychiatry, University La Sapienza, Rome, Italy;Department of Neuroscience, Headache Centre, University of Parma, Parma, Italy;Neurology Clinic, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy;University Centre for Adaptive Disorders and Head pain (UCADH), Pavia, Italy;University Centre for Adaptive Disorders and Head pain (UCADH), Pavia, Italy;Headache Medicine Centre, Policlinic of Monza, Monza, Italy;University Consortium for Adaptive Disorders and Head pain (UCADH), Via Mondino 2, 27100, Pavia, Italy;University Centre for Adaptive Disorders and Head pain (UCADH), Pavia, Italy;National Institute of Neurology IRCCS C, Mondino Foundation Pavia, Pavia, Italy;

关键词: Migraine;    Comorbidity;    Psychiatric disorders;    Depression;    Meta-analysis;   

DOI  :  10.1007/s10194-010-0282-4

 received in 2010-09-08, accepted in 2010-12-16,  发布年份 2011

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© The Author(s) 2011