Migraine and its psychiatric comorbidities

Abstract

Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity.

Point Prevalence of Co-Occurring Behavioral Health Conditions and Associated Chronic Disease Burden Among Adolescents

“…9,16,24,25 We found a particularly strong association between irritable bowel syndrome and anxiety, which is not surprising, as anxiety and stress are thought to exacerbate the symptoms of irritable bowel syndrome. 31 Similarly, migraine has been found to be related to a number of psychiatric comorbidities, 32,33 which could represent some shared vulnerability or emotional distress resulting from dealing with the chronic pain of migraine. However, based on this study, it is difficult to know for certain whether there is a bidirectional relationship between BHCs and co-occurring medical conditions, or whether the conditions are related to some shared vulnerability or physiological mechanism.…”

Migraine Burden of Disease: From the Patient's Experience to a Socio‐Economic View

“…Comorbid conditions, especially if untreated or left uncontrolled may affect a patient's QoL . Comorbid psychiatric conditions for example, have been shown to increase migraine‐related disability, reduce QoL, and also negatively impact treatment outcomes .…”

Body composition status and the risk of migraine

“…This finding substantiates the data demonstrating an association between obesity and an increased risk of migraine and emphasizes the importance of age and sex as covariates. 1 While this increased risk is moderate (being of similar magnitude to the risk associated with ischemic heart disease 29,30 and bipolar disorders 31 ), the recognition of this risk is important given that obesity is a potentially modifiable disease risk factor for migraine. Further, it supports the need for research to determine whether interventions to reduce obesity decrease the risk of migraine.…”