Migraine headaches in Bipolar Disorder
July 24, 2010 by Leslie E. Packer PhD
Filed under Research
Migraine headaches have been reported to be comorbid with Tourette’s Syndrome. Because Tourette’s is often comorbid with Obsessive-Compulsive Disorder (OCD), which, in turn, is often comorbid with Bipolar Disorder, it should not surprise anyone to find a significant co-morbidity between OCD, Bipolar Disorder, and migraine headaches, even though until now, there have been no controlled studies that indicate any significant comorbidity between OCD and migraine.
A recent study demonstrates that the rate of comorbidity may be even higher than some of us had thought: one out of every five patients with BP-I had migraine headaches while more than one out of every three patients with BP-II had migraine headaches. Bipolar patients who had comorbid migraine exhibited significantly higher rates of suicidal behavior, social phobia, panic disorder, generalized anxiety disorder, and OCD. Here’s the abstract from the study:
OBJECTIVE: In two related studies, we explored the prevalence of migraine and its associated clinical characteristics in patients with bipolar disorder (BD) as well as psychiatric morbidity in patients treated for migraine.
METHOD: The first study included 323 subjects with BD type I (BD I) or BD type II (BD II), diagnosed using the Schedule for Affective Disorders and Schizophrenia, Lifetime version (SADS-L) format, or the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). Migraine history was assessed by means of a structured questionnaire. In a second sample of 102 migraine patients, we investigated current and lifetime psychiatric morbidity using the SADS-L. Statistical analyses were conducted using nonparametric analysis and log-linear models.
RESULTS: A total of 24.5% of BD patients had comorbid migraine; those with BD II had a higher prevalence (34.8%) compared to BD I (19.1%) (p < 0.005). BD patients with comorbid migraine had significantly higher rates of suicidal behaviour, social phobia, panic disorder, generalized anxiety disorder, and obsessive-compulsive disorder (all p < 0.05). In the sample of migraine patients, 34.3% had a current psychiatric diagnosis, and 73.5% had a lifetime psychiatric diagnosis. The prevalence of BD I was 4.9%, and 7.8% for BD II. DISCUSSION: Migraine is prevalent within the BD population, particularly among BD II subjects. It is associated with an increased risk of suicidal behaviour and comorbid anxiety disorders. Conversely, migraine sufferers have high rates of current and lifetime psychopathology. A greater understanding of this comorbidity may contribute to our knowledge of the underlying mechanisms of BD.
Reference:
Ortiz A, Cervantes P, Zlotnik G, van de Velde C, Slaney C, Garnham J, Turecki G, O’Donovan C, Alda M: Cross-prevalence of migraine and bipolar disorder. Bipolar Disord. 2010 Jun;12(4):397-403.
