McIntyre Roger S, Konarski Jakub Z, Wilkins Kathryn, Bouffard Beverley, Soczynska Joanna K, Kennedy Sidney H
Department of Psychiatry, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, Toronto, ON, Canada M5T 2S8.
Headache. 2006 Jun;46(6):973-82. doi: 10.1111/j.1526-4610.2006.00469.x.
To report on the prevalence of comorbid migraine in bipolar disorder and the implications for bipolar age of onset, psychiatric comorbidity, illness course, functional outcome, and medical service utilization.
Migraine comorbidity is differentially reported in bipolar versus unipolar depressed clinical samples. The bipolar disorder-migraine association and its consequences have been infrequently reported in epidemiological studies.
Data for this analysis were derived from respondents (n = 36 984) to the Canadian Community Health Survey - Mental Health and Well-Being (CCHS). Respondents reporting a lifetime WHO-CIDI-defined manic episode and physician-diagnosed migraine (lifetime) were compared to respondents without migraine on sociodemography, course of illness, and medical service utilization indices.
An estimated 2.4% of the sample met criteria for bipolar disorder. Persons with bipolar disorder had a relatively higher prevalence of migraine versus the general population (24.8% vs. 10.3%; P < .05). The sex-specific prevalence of comorbid migraine in bipolar disorder was 14.9% for males and 34.7% for females. Bipolar males with comorbid migraine were more likely to live in a low income household (P < .05); receive welfare and social assistance (P < .05); report an earlier age of onset of bipolar disorder (P < .05); and have a higher lifetime prevalence of comorbid anxiety disorders (P < .05). Bipolar males with comorbid migraine were also more likely to utilize primary (P < .05) and mental health care services (P < .05) . Bipolar females with comorbid migraine had more comorbid medical disorders (P < .05) and were more likely to require help with personal or instrumental activities of daily living when compared to bipolar females without migraine.
Bipolar disorder with comorbid migraine is prevalent and associated with greater dysfunction and medical service utilization, notable in males. Opportunistic screening and surveillance for bipolar and comorbid migraine is warranted.
报告双相情感障碍中共病偏头痛的患病率，以及其对双相情感障碍起病年龄、精神疾病共病、病程、功能结局和医疗服务利用的影响。
在双相情感障碍与单相抑郁的临床样本中，偏头痛共病的报告存在差异。双相情感障碍与偏头痛的关联及其后果在流行病学研究中鲜有报道。
本分析的数据来自加拿大社区健康调查-心理健康与幸福感（CCHS）的受访者（n = 36984）。将报告有世界卫生组织复合性国际诊断交谈表（WHO-CIDI）定义的终生躁狂发作且经医生诊断为偏头痛（终生）的受访者，与无偏头痛的受访者在社会人口统计学、病程和医疗服务利用指标方面进行比较。
估计样本中有2.4%符合双相情感障碍标准。双相情感障碍患者中偏头痛的患病率相对于普通人群较高（24.8%对10.3%；P <.05）。双相情感障碍中共病偏头痛的男性患病率为14.9%，女性为34.7%。患有共病偏头痛的双相情感障碍男性更有可能生活在低收入家庭（P <.05）；接受福利和社会援助（P <.05）；报告双相情感障碍起病年龄较早（P <.05）；并且共病焦虑障碍的终生患病率较高（P <.05）。患有共病偏头痛的双相情感障碍男性也更有可能利用初级医疗服务（P <.05）和精神卫生保健服务（P <.05）。与无偏头痛的双相情感障碍女性相比，患有共病偏头痛的双相情感障碍女性有更多的共病躯体疾病（P <.05），并且在日常生活的个人或工具性活动方面更有可能需要帮助。
伴有共病偏头痛的双相情感障碍很常见，并且与更大的功能障碍和医疗服务利用相关，在男性中尤为明显。有必要对双相情感障碍和共病偏头痛进行机会性筛查和监测。
