Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Headache. 2022 May;62(5):634-641. doi: 10.1111/head.14306. Epub 2022 May 6.
This study explored the risk of migraine in children, adolescents, and young adults with attention deficit hyperactivity disorder (ADHD) and its association with ADHD medications.
The prevalence of migraine peaks between the ages of 35 and 39 years. Recent studies have reported a positive association between ADHD and migraine.
This longitudinal case-cohort study was conducted using data from the Taiwan National Health Insurance Database. Between 2001 and 2009, we enrolled 81,441 participants with ADHD and a 1:1-matched control cohort for age, sex, and physical and psychiatric comorbidities. All participants had no diagnosis of migraine before enrollment and were followed up to the end of 2011. We examined the risk of newly diagnosed migraine among patients with ADHD and matched controls after adjusting for demographics and physical/psychiatric comorbidities.
Patients with ADHD had a higher incidence of migraine than those in the control group (462/81441 [0.6%] vs. 212/81441 [0.3%] patients, p < 0.001). After adjusting for potential confounders, the hazard ratio (HR) was 1.92 (95% CI, 1.64-2.34) for migraine in patients with ADHD versus controls. The subgroup analyses stratified by age showed the HRs were 2.01 (95% CI, 1.63-2.49), 1.94 (95% CI, 1.35-2.79), and 1.31 (95% CI, 0.58-2.98) for children (<12 years old), adolescents (12-17), and young adults (18-29), respectively, versus controls. When stratified by sex, the HR was 1.97 (95% CI, 1.58-2.46) for men and 1.94 (95% CI, 1.44-2.62) for women versus controls. The cumulative daily dose of ADHD medications was not associated with the risk of migraine.
Children and adolescents with ADHD were associated with an increased risk of migraine compared with matched controls. The increased risk was not observed in young adults with ADHD. Further studies are required to examine the mechanisms between migraine and ADHD.
本研究旨在探讨儿童、青少年和青年期注意缺陷多动障碍（ADHD）患者偏头痛的发病风险及其与 ADHD 药物的相关性。
偏头痛的患病率高峰在 35 至 39 岁之间。最近的研究报告称，ADHD 与偏头痛之间存在正相关关系。
这是一项使用 2001 年至 2009 年台湾全民健康保险数据库进行的纵向病例队列研究。共纳入 81441 例 ADHD 患者和年龄、性别、身体和精神合并症相匹配的对照组。所有参与者在入组前均无偏头痛诊断，并随访至 2011 年底。在调整人口统计学和身体/精神合并症后，我们检查了 ADHD 患者和匹配对照组中新诊断偏头痛的风险。
与对照组相比，ADHD 患者偏头痛的发病率更高（462/81441[0.6%]vs.212/81441[0.3%]患者，p<0.001）。在调整潜在混杂因素后，ADHD 患者偏头痛的风险比（HR）为 1.92（95%CI，1.64-2.34）。按年龄分层的亚组分析显示，儿童（<12 岁）、青少年（12-17 岁）和青年期（18-29 岁）的 HR 分别为 2.01（95%CI，1.63-2.49）、1.94（95%CI，1.35-2.79）和 1.31（95%CI，0.58-2.98），对照组。按性别分层时，男性的 HR 为 1.97（95%CI，1.58-2.46），女性为 1.94（95%CI，1.44-2.62），对照组。ADHD 药物的累积日剂量与偏头痛风险无关。
与匹配对照组相比，儿童和青少年 ADHD 患者偏头痛的发病风险增加。ADHD 青年期患者的风险增加不明显。需要进一步研究来检查偏头痛和 ADHD 之间的机制。
