Migraine often associated with psychiatric disorders

NEW YORK (Reuters Health) - Migraine is commonly associated with a variety of psychiatric disorders, including depression, bipolar disorder, panic disorder, and social phobia, a new study shows.

"In addition, having migraine and a psychiatric condition is associated with worsened health-related outcomes (disability, quality of life, restriction of activities)," Dr. Nathalie Jette from University of Calgary, Alberta, Canada told Reuters Health.

Jette and colleagues sought to determine the prevalence of various psychiatric conditions in association with migraine and to describe the pattern of association of this "comorbidity" with a variety of health-related outcomes.

They report in the journal Headache that study subjects with migraine had a higher lifetime and 12-month prevalence of major depressive disorder, bipolar disorder, panic disorder, and social phobia, relative to migraine-free study subjects.

The association between migraine and psychiatric disorders did not differ significantly according to gender, age, place of residence, or level of education.

The researchers also found that having migraine and any mental health disorder increased the chance that patients would have 2-week disability, restriction of activities, poorer quality-of-life, or mental health care use.

Jette said: "Assessing individuals with migraine for coexisting psychiatric conditions is very important to adequately manage this patient population and to guide public health policies regarding health services utilization and healthcare costs."

"Not recognizing psychiatric comorbidities in migraine could result in an increased burden to the patient, their families, and society," she warned.

"We strongly believe that patients with migraine and a psychiatric comorbidity such as anxiety and/or depression are best treated as part of a multidisciplinary program and that medications alone are often not sufficient to address these comorbid conditions," Jette added.

"The treatment of migraine is complex and requires significant time and effort on the part of both the patient and the physician," she concluded. "More specialized programs are often needed to treat those with refractory or difficult migraine, including in particular those with psychiatric comorbidity."

SOURCE: Headache, April 2008.