慢性每日头痛和偏头痛患者的精神共病:包括人格特质和自杀风险的选择性综述
Psychiatric comorbidity in patients with chronic daily headache and migraine: a selective overview including personality traits and suicide risk.
作者信息
Pompili Maurizio, Di Cosimo Daniela, Innamorati Marco, Lester David, Tatarelli Roberto, Martelletti Paolo
机构信息
Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, 1035 Via di Grottarossa, Rome 00189, Italy.
出版信息
J Headache Pain. 2009 Aug;10(4):283-90. doi: 10.1007/s10194-009-0134-2. Epub 2009 Jun 25.
Studies on the prevalence and impact of psychiatric disorders among headache patients have yielded findings that have clarified the relationship between migraine and major affective disorders, anxiety, illicit drug abuse, nicotine dependence, and suicide attempts. Studies in both clinical and community-based settings have demonstrated an association between migraine and a number of specific psychiatric disorders. In large-scale population-based studies, persons with migraine are from 2.2 to 4.0 times more likely to have depression. In longitudinal studies, the evidence supports a bidirectional relationship between migraine and depression, with each disorder increasing the risk of the other disorder. Although a strong association has been demonstrated consistently for migraine and major depression, especially for migraine with aura, there has been less systematic research on the links between migraine and bipolar disorder. This review will focus on the way in which psychiatric disorders decrease the quality of life and result in a worse prognosis, chronicity of the disease, and a worse response to treatment. Short-term pharmaceutical care intervention improves the patients' mental health, but it does not significantly change the number and severity of headaches. The increase in self-efficacy and mental health associated with pharmaceutical care may be instrumental in improving the long-term pharmacotherapy of patients with migraine and headache.
关于头痛患者精神障碍的患病率及其影响的研究已得出一些结果,这些结果阐明了偏头痛与重度情感障碍、焦虑、药物滥用、尼古丁依赖及自杀未遂之间的关系。临床研究和基于社区的研究均表明偏头痛与多种特定精神障碍之间存在关联。在大规模的基于人群的研究中,偏头痛患者患抑郁症的可能性是常人的2.2至4.0倍。在纵向研究中,有证据支持偏头痛与抑郁症之间存在双向关系,即每种疾病都会增加另一种疾病的发病风险。尽管偏头痛与重度抑郁症之间始终存在很强的关联,尤其是有先兆的偏头痛,但关于偏头痛与双相情感障碍之间联系的系统性研究较少。本综述将聚焦于精神障碍降低生活质量并导致预后更差、疾病慢性化及治疗反应更差的方式。短期药学服务干预可改善患者的心理健康,但不会显著改变头痛的次数和严重程度。与药学服务相关的自我效能感和心理健康的提升可能有助于改善偏头痛和头痛患者的长期药物治疗。
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