Fasmer Ole Bernt, Oedegaard Ketil Joachim
Psykiatrisk institutt, Universitetet i Bergen, Haukeland Universitetssykehus, 5021 Bergen.
Tidsskr Nor Laegeforen. 2004 Sep 23;124(18):2350-3.
Migraine, mood disorders and anxiety disorders are common afflictions in the general population, with similar life-time prevalence rates, 10-20%. These disorders share many clinical features and the pathogenetic mechanisms may possibly be similar.
This review is based on Medline searches for relevant literature.
Migraine typically occurs in the form of attacks. Panic disorder, the anxiety disorder most strongly linked to migraine, also occurs in attacks. Mood swings, both depressive and hypomanic, are often of short duration in many patients and can last only a couple of days; hence the course of these disorders has more similarities than is usually appreciated. Psychiatric symptoms are often seen in the course of a migraine attack. Epidemiological studies have shown strong comorbidity between these disorders. Migraine patients have higher prevalence of both anxiety disorders and depressions. There seems to be a particularly strong association between bipolar II disorder and migraine. Disturbances in monoaminergic systems, primarily the serotonergic, may represent pathophysiological mechanisms with regard to migraine and mood and anxiety disorders. Some drugs are effective in the treatment of all these disorders; the most important drugs are tricyclic antidepressants and valproate.
There are clear connections between migraine and psychiatric disorders and the attending physician should have them in mind.
偏头痛、情绪障碍和焦虑症是普通人群中的常见疾病，终生患病率相似，为10%-20%。这些疾病具有许多共同的临床特征，其发病机制可能相似。
本综述基于对相关文献的Medline检索。
偏头痛通常以发作形式出现。惊恐障碍是与偏头痛联系最紧密的焦虑症，也以发作形式出现。许多患者的情绪波动，包括抑郁和轻躁狂，往往持续时间较短，可能仅持续几天；因此，这些疾病的病程比通常认为的有更多相似之处。在偏头痛发作过程中常可见精神症状。流行病学研究表明这些疾病之间存在很强的共病性。偏头痛患者患焦虑症和抑郁症的患病率更高。双相II型障碍与偏头痛之间似乎存在特别强的关联。单胺能系统紊乱，主要是5-羟色胺能系统紊乱，可能是偏头痛以及情绪和焦虑症的病理生理机制。一些药物对所有这些疾病的治疗均有效；最重要的药物是三环类抗抑郁药和丙戊酸盐。
偏头痛与精神障碍之间存在明确的联系，主治医生应予以关注。
