Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Bipolar Disord. 2010 Jun;12(4):397-403. doi: 10.1111/j.1399-5618.2010.00832.x.
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.
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.
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.
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.
在两项相关研究中，我们探讨了双相障碍（BD）患者偏头痛的患病率及其相关临床特征，以及偏头痛治疗患者的精神疾病发病率。
第一项研究纳入了 323 例使用心境障碍和精神分裂症定式检查（SADS-L）或DSM-IV 轴 I 障碍定式临床检查（SCID）诊断为 I 型 BD（BD I）或 II 型 BD（BD II）的患者。偏头痛病史通过结构化问卷进行评估。在第二项由 102 例偏头痛患者组成的样本中，我们使用 SADS-L 调查了当前和终生的精神疾病发病率。使用非参数分析和对数线性模型进行统计分析。
BD 患者中共有 24.5%合并偏头痛；BD II 患者的患病率（34.8%）高于 BD I（19.1%）（p < 0.005）。合并偏头痛的 BD 患者自杀行为、社交恐惧症、惊恐障碍、广泛性焦虑症和强迫症的发生率明显更高（均 p < 0.05）。在偏头痛患者样本中，34.3%有当前的精神科诊断，73.5%有终生的精神科诊断。BD I 的患病率为 4.9%，BD II 的患病率为 7.8%。
偏头痛在 BD 人群中较为常见，尤其是在 BD II 患者中。它与自杀行为和共患焦虑障碍的风险增加有关。相反，偏头痛患者的当前和终生精神病理发生率较高。对这种共病的更深入了解可能有助于我们对 BD 的潜在机制的认识。
