Department of Neurology, Albert Einstein College of Medicine and Montefiore Headache Center, Bronx, NY, USA.
J Neurol. 2013 Aug;260(8):1960-9. doi: 10.1007/s00415-012-6725-x. Epub 2012 Nov 7.
Migraine is a prevalent disabling neurological disorder associated with a wide range of medical and psychiatric comorbidities. Population- and clinic-based studies suggest that psychiatric comorbidities, particularly mood and anxiety disorders, are more common among persons with chronic migraine than among those with episodic migraine. Additional studies suggest that psychiatric comorbidities may be a risk factor for migraine chronification (i.e., progression from episodic to chronic migraine). It is important to identify and appropriately treat comorbid psychiatric conditions in persons with migraine, as these conditions may contribute to increased migraine-related disability and impact, diminished health-related quality of life, and poor treatment outcomes. Here, we review the current literature on the rates of several psychiatric comorbidities, including depression, anxiety, and post-traumatic stress disorder, among persons with migraine in clinic- and population-based studies. We also review the link between physical, emotional, and substance abuse, psychiatric disorders, and migraine. Finally, we review the data on psychiatric risk factors for migraine chronification and explore theories and evidence underlying the comorbidity between migraine and these psychiatric disorders.
偏头痛是一种常见的使人丧失能力的神经疾病，与多种医学和精神共病相关。基于人群和诊所的研究表明，与偶发性偏头痛患者相比，慢性偏头痛患者更常见精神共病，特别是情绪和焦虑障碍。其他研究表明，精神共病可能是偏头痛慢性化（即从偶发性偏头痛进展为慢性偏头痛）的一个危险因素。识别和适当治疗偏头痛患者的共病精神状况非常重要，因为这些状况可能导致偏头痛相关残疾和影响增加、健康相关生活质量下降和治疗效果不佳。在这里，我们回顾了关于偏头痛患者在诊所和人群研究中出现抑郁、焦虑和创伤后应激障碍等几种精神共病的现有文献。我们还回顾了躯体、情感和物质滥用、精神障碍与偏头痛之间的关联。最后，我们回顾了关于偏头痛慢性化的精神危险因素的数据，并探讨了偏头痛与这些精神障碍之间共病的理论和证据。
