Department of Neurology, NYU Langone Health, 222 East 41st Street, New York, NY, 10017, USA.
Curr Pain Headache Rep. 2023 Sep;27(9):461-469. doi: 10.1007/s11916-023-01123-4. Epub 2023 Jun 29.
We evaluate the evolving evidence of psychiatric comorbidities associated with episodic migraine. Utilizing recent research publications, we aim to assess traditional treatment option considerations and discuss recent and evolving non-pharmacologic treatment progress for episodic migraine and related psychiatric conditions.
Recent findings indicate that episodic migraine is strongly linked to comorbid depression, anxiety, posttraumatic stress disorder, and sleep disorders. Not only do patients with episodic migraine have higher rates of psychiatric comorbidity, but a higher number of headache days reported is also strongly linked to an increased risk of developing a psychiatric disorder, indicating there may be a link between frequency and psychiatric comorbidity and that patients with high-frequency episodic migraine should be assessed for psychiatric comorbidity. Few migraine preventive medications have examined the effect of the medication on both migraine and psychiatric comorbidity though we discuss what has been reported in the literature. Non-pharmacologic-based treatments including behavioral therapies and mind-body interventions previously developed for psychiatric conditions, e.g., mindfulness-based CBT (MBCT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) therapy, have promising results for patients diagnosed with episodic migraine and may therefore be useful in treating migraine and comorbid psychiatric conditions. Psychiatric comorbidity may affect the efficacy of the treatment of episodic migraine. Thus, we must assess for psychiatric comorbidities to inform better treatment plans for patients. Providing patients with episodic migraine with alternate modalities of treatment may help to improve patient-centered care and increase patients' sense of self-efficacy.
我们评估与发作性偏头痛相关的精神共病的不断发展的证据。利用最近的研究出版物，我们旨在评估传统治疗选择的考虑因素，并讨论发作性偏头痛和相关精神疾病的最新和不断发展的非药物治疗进展。
最近的研究结果表明，发作性偏头痛与共病抑郁、焦虑、创伤后应激障碍和睡眠障碍密切相关。发作性偏头痛患者不仅精神共病率较高，而且报告的头痛天数较多也与患精神障碍的风险增加密切相关，这表明头痛频率与精神共病之间可能存在关联，高频发作性偏头痛患者应评估精神共病。尽管我们讨论了文献中的报告，但很少有偏头痛预防药物研究过药物对偏头痛和精神共病的影响。基于非药物的治疗方法包括行为疗法和身心干预措施，以前是为精神疾病开发的，例如基于正念的认知疗法 (MBCT)、接受和承诺疗法 (ACT) 和正念减压疗法 (MBSR)，对于诊断为发作性偏头痛的患者有很好的效果，因此可能对治疗偏头痛和共病精神疾病有用。精神共病可能会影响发作性偏头痛治疗的效果。因此，我们必须评估精神共病，为患者提供更好的治疗计划。为发作性偏头痛患者提供替代治疗方法可能有助于改善以患者为中心的护理，并提高患者的自我效能感。
