Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Bipolar Disord. 2021 May;23(3):255-262. doi: 10.1111/bdi.12972. Epub 2020 Jul 16.
There is substantial evidence of increased prevalence of migraines, and negative psychiatric correlates of migraines, in adults with bipolar disorder (BD). Given the paucity of data on this topic in youth, we investigated the prevalence and correlates of migraine in a large sample of adolescents with BD.
The study included 165 adolescents with BD-I, -II, or -not otherwise specified (NOS), diagnosed via the KSADS-PL semi-structured interview, and 89 healthy controls (HCs). Non-migraine headache and migraine headache was evaluated using the validated ID-Migraine 3-item screener.
Although the prevalence of non-migraine headaches did not differ between adolescents with BD (24.2%) and HCs (32.6%; P = .15), migraine was significantly more prevalent among adolescents with BD (38.2%) compared to HCs (3.4%; adjusted odds ratio 14.76, 95% confidence interval 4.39-49.57; P < .001). Within BD, migraine was associated with female sex, BD-II/-NOS subtype, less severe worst past functioning, higher past depression severity, higher self-reported affective lability, higher body mass index, and less use of lithium and second-generation antipsychotics.
Migraine is much more prevalent among adolescents with BD compared to HCs; the magnitude of this association exceeds what has been reported in adult samples. Correlates of migraine in youth BD are similar to those found for adults, including the link with the depressive polarity of BD. Future prospective studies are warranted to evaluate temporal associations between migraine and mood symptoms, and to evaluate neurobiological and cardiovascular underpinnings of these associations.
有大量证据表明，双相障碍（BD）成年患者偏头痛的发病率更高，且偏头痛与负面精神相关。鉴于该主题在青少年人群中数据稀缺，我们调查了大量青少年 BD 患者偏头痛的患病率及其相关因素。
该研究纳入了 165 名经 KSADS-PL 半定式访谈诊断为 BD-I、BD-II 或未特定型（NOS）的青少年患者，以及 89 名健康对照者（HCs）。使用经过验证的 ID-Migraine 3 项筛查工具评估非偏头痛性头痛和偏头痛性头痛。
尽管 BD 青少年（24.2%）和 HCs（32.6%）的非偏头痛性头痛患病率无差异（P=0.15），但偏头痛在 BD 青少年（38.2%）中明显更为常见，而在 HCs 中为 3.4%（调整后优势比 14.76，95%置信区间 4.39-49.57；P<0.001）。在 BD 中，偏头痛与女性、BD-II/NOS 亚型、过去最差功能障碍程度较轻、过去抑郁严重程度较高、自我报告的情感波动性较高、体重指数较高、锂盐和第二代抗精神病药物使用率较低有关。
与 HCs 相比，BD 青少年偏头痛的发病率更高；这种关联的幅度超过了在成年人群中报告的幅度。BD 青少年偏头痛的相关因素与成年人相似，包括与 BD 抑郁极性的关联。未来需要前瞻性研究来评估偏头痛与情绪症状之间的时间关联，并评估这些关联的神经生物学和心血管基础。
