Cross-prevalence of migraine and bipolar disorder

Authors


  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

  • This work was presented at the Colloquium for Junior Investigators, 162nd American Psychiatric Association Annual Meeting, San Francisco, CA, USA, May 16-21, 2009.

Corresponding author:
Martin Alda, MD, FRCPC
Department of Psychiatry
Dalhousie University
5909 Veterans’ Memorial Lane
Abbie J. Lane Building, Room 3088
Halifax, Nova Scotia, B3H 2E2, Canada
Fax: (902) 473-4877
E-mail: malda@dal.ca

Abstract

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: 12: 397–403. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

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.

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