Phobias, other psychiatric comorbidities and chronic migraine

Abstract

-B a c k g round: Comorbidity of chronic migraine (CM) with psychiatric disorders, mostly anxiety and mood disorders, is a well-recognized phenomenon. Phobias are one of the most common anxiety diso rders in the general population. Phobias are more common in migraineurs than non-migraineurs. The clinical profile of phobias in CM has never been studied. Method: We investigated the psychiatric profile in 56 patients with CM using the SCID I/P interview. Results: Lifetime criteria for at least one mental d i s o rder was found in 87.5% of the sample; 75% met criteria for at least one lifetime anxiety disorder and 60.7% of our sample fulfilled DSM-IV criteria for lifetime phobic avoidant disorders. Mood and anxiety s c o res were higher in phobic patients than in non-phobic CM controls. Number of phobias correlated with higher levels of anxiety and depre s s i o n . Conclusion: Phobias are common in CM. Its recognition may influence its management. Early treatment may lead to better prognosis.KEY WORDS: headache, migraine, anxiety, phobias. Fobias, outras comorbidades psiquiátricas e enxaqueca crônicaRESUMO -I n t rodução: As comorbidades psiquiátricas das enxaquecas crônicas são bem conhecidas. As fobias, transtorno ansioso mais comum, são mais prevalentes entre enxaquecosos do que entre não enxaquecosos. O perfil clínico de fobias em uma população enxaquecosa nunca foi estudado. M é t o d o : Estudamos aspectos psiquiátricos de uma população de 56 pacientes com enxaqueca crônica. R e s u l t a d o s :Usando o SCID I/P para o DSM-IV, critérios diagnósticos para ao menos algum transtorno psiquiátrico durante a vida foram preenchidos por 87,5% de nossa amostra, 75% para ao menos um transtorno ansioso e 60,7% para condições fóbicas em algum momento de suas vidas. Os escores de ansiedade e humor foram maiore s e n t re os fóbicos e o número de fobias teve correlação positiva com o grau de ansiedade e depre s s ã o . Conclusão: Fobias são comuns na enxaqueca crônica e seu reconhecimento poderia influenciar seu manejo e melhorar seu prognóstico.

Overattachment and perceived disability in chronic migraineurs

“…In our sample, 15% of migraine patients reported current moderate to severe depression, a figure lower than other studies which have investigated psychiatric comorbidity in migraine patients [62,63]. For example, McWilliams, Goodwin, and Cox investigated associations between three pain conditions and three common psychiatric disorders (depression, panic attacks, and generalized anxiety) in a representative sample of US adults aged 25-74 [63].…”

Headache in Children and Adolescents

“…Epidemiological studies have established a strong association between primary headaches and psychiatric disorders and the reported rates ranged between 56.4-70.3% in migraine and 36.4-77.8 % in TTH [30,[48][49][50][51][52] . In one study, 29.6% of CDH patients met criteria for at least one current psychiatric diagnosis, and 34.9% met criteria for at least one-lifetime psychiatric diagnosis [53] .…”

“…In one study, 29.6% of CDH patients met criteria for at least one current psychiatric diagnosis, and 34.9% met criteria for at least one-lifetime psychiatric diagnosis [53] . Depressive and anxiety disorders being the common disorders, other being dysthymia, phobic disorder, obsessive compulsive disorder, somatoform disorders, sleep difficulties and disorders (insufficient and poorer sleep quality, co-sleeping with parents, anxiety related to sleep, night waking, nightmares, bedwetting and pavor), suicidal ideation and an increased risk of suicidality [30,48,[50][51][52][54][55][56][57][58][59][60][61] .The lifetime prevalence of major depression was threefold higher in persons with migraine and in persons with a severe headache compared with controls [62] .TTH is associated with fewer close friends and had a higher rate of divorced parents [63] . Previous studies have shown a significant negative correlation between total intelligence quotient, verbal intelligence quotient, performance intelligence quotient and the frequency of headache attacks [64] .…”

Ansiedade e Depressão em Pacientes Migranosos

“…São doenças muito prevalentes na população geral, atingem mais as mulheres e, frequentemente, estão associadas. Estudos prévios indicam que há correlação entre pacientes migranosos e comorbidades psiquiátri-cas [9][10][11][12][13] . Há, principalmente, evidências de uma associação não casual entre migrânea, depressão maior e distúrbios de ansiedade [14][15][16] .…”