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29-11-2011 | Psychology | Article

Comorbid migraine linked to poorer outcomes in BD patients


Free abstract

MedWire News: Patients with bipolar disorder (BD) who also suffer from migraine have poorer outcomes than those who do not experience such headaches, results from a Brazilian study suggest.

"Recent evidence suggests an association between migraine and BD," say Elisa Brietzke (Universidade de São Paulo) and team. "Some studies have reported that the prevalence rates of migraine among individuals with BD may be as high as 39%."

But they add that little is known about the impact of comorbid migraine on the clinical course of BD.

To investigate, the team studied 339 patients with BD, aged an average of 42 years, of whom 115 (33.9%) had comorbid migraine. There were no significant demographic differences between the groups, except for gender distribution, with women comprising 82.6% of the migraine group compared with 65.2% of the nonmigraine group.

After accounting for age and other potential confounding factors, the researchers found that BD patients with migraine had experienced a significantly higher number of mood episodes than those without migraine, at a median of 19.0 versus 7.0.

The difference in the number of mood episodes between BD patients with and without migraine was mainly accounted for by depressive episodes, at a median of 10.0 versus 3.0, with no significant differences in manic episodes, at 5.5 versus 5.0.

The researchers also found that 72.6% of BD patients with migraine had at least one other psychiatric disorder compared with just 47.4% of those without migraine.

Furthermore, 64.3% of BD patients with migraine had at least one general medical comorbidity compared with just 44.2% of those without migraine.

There were no significant differences between the groups in terms of lifetime number of hospitalizations for depression or mania, rapid cycling rates, and history of suicide attempts.

Brietzke and colleagues conclude in the journal Comprehensive Psychiatry: "Comorbid migraine seems to be associated with poor outcomes in BD."

They add: "The harmful impact of comorbid migraine suggests the existence of pathophysiologic intersections between the two disorders, which should be explored in future studies about the neurobiology of these illnesses. In addition, the adequate treatment of migraine may have a beneficial long-term impact for patients who have both conditions."

By Mark Cowen

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