Psychiatric comorbidities of episodic and chronic migraine
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Migraine is a prevalent disabling neurological disorder associated with a wide range of medical and psychiatric comorbidities. Population- and clinic-based studies suggest that psychiatric comorbidities, particularly mood and anxiety disorders, are more common among persons with chronic migraine than among those with episodic migraine. Additional studies suggest that psychiatric comorbidities may be a risk factor for migraine chronification (i.e., progression from episodic to chronic migraine). It is important to identify and appropriately treat comorbid psychiatric conditions in persons with migraine, as these conditions may contribute to increased migraine-related disability and impact, diminished health-related quality of life, and poor treatment outcomes. Here, we review the current literature on the rates of several psychiatric comorbidities, including depression, anxiety, and post-traumatic stress disorder, among persons with migraine in clinic- and population-based studies. We also review the link between physical, emotional, and substance abuse, psychiatric disorders, and migraine. Finally, we review the data on psychiatric risk factors for migraine chronification and explore theories and evidence underlying the comorbidity between migraine and these psychiatric disorders.
KeywordsChronification Comorbidity Migraine Psychiatric Depression Anxiety
The authors thank Allergan, Inc., for funding Imprint Publication Science, New York, NY, to provide editorial support in the preparation and styling of this manuscript.
Conflicts of interest
Dawn C. Buse has received grant support and honoraria from Allergan, Endo Pharmaceuticals, Iroko Pharmaceuticals, MAP Pharmaceuticals, Merck & Co., Inc., Novartis, and NuPathe. Stephen D. Silberstein is on the advisory panel of and receives honoraria from Allergan, Amgen, Capnia, Coherex, GlaxoSmithKline, Iroko Pharmaceuticals, Lilly, MAP, Medtronic, Merck, Neuralieve, NINDS, NuPathe, Pfizer, and St. Jude Medical; and serves as a consultant for and receives honoraria from Amgen, MAP, Nautilus, Opti-Nose, and Zogenix. His employer received research support from Allergan, BMS, Cumberland, ElectroCore, Lilly, Merck, Opti-Nose, St. Jude Medical, and Troy Healthcare. Aubrey N. Manack is an employee of Allergan, Inc. Spyros Papapetropoulos is a former employee of Allergan, Inc., and currently employed at Pfizer Inc. Richard B. Lipton receives research support from the NIH [PO1 AG03949 (Program Director), PO1AG027734 (Project Leader), RO1AG025119 (Investigator), RO1AG022374-06A2 (Investigator), RO1AG034119 (Investigator), RO1AG12101 (Investigator), K23AG030857 (Mentor), K23NS05140901A1 (Mentor), and K23NS47256 (Mentor)], the National Headache Foundation, and the Migraine Research Fund; serves on the editorial boards of Neurology and Cephalalgia and as senior advisor to Headache; has reviewed for the NIA and NINDS; holds stock options in eNeura Therapeutics (a company without commercial products); serves as consultant or advisory board member for or has received honoraria from: Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol-Myers Squibb, Cognimed, Colucid, Eli Lilly, eNeura Therapeutics, GlaxoSmithKline, MAP, Merck, Nautilus Neuroscience, Novartis, NuPathe, Pfizer, and Vedanta.
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