Elsevier

Neurologic Clinics

Volume 15, Issue 1, 1 February 1997, Pages 115-123
Neurologic Clinics

COMORBIDITY OF MIGRAINE AND PSYCHIATRIC DISORDERS

https://doi.org/10.1016/S0733-8619(05)70298-XGet rights and content
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There is now substantial evidence to corroborate early anecdotal clinical descriptions regarding the co-occurrence of migraine and psychiatric disorders. Clinicians involved in the treatment of migraine often have described a set of characteristic features of migraineurs that include anxiety, depression, and social fears. Wolff33 in 1937 was so convinced of this constellation of attributes that he is often credited as being the initiator of the concept of the purported migraine personality. More careful inspection of his description, however, reveals that the characteristics of extreme physical fatigue, apathy, and anxious anticipation are more akin to psychiatric symptoms than personality traits. Earlier descriptions of these characteristics also can be found throughout the clinical literature. The most common features of these descriptions are depression characterized by anergia and anxiety disorders, particularly panic disorder and phobia. The contemporary equivalent to these features are the atypical subtype of depression.

This article reviews the evidence for comorbidity of migraine with psychiatric disorders, particularly the affective and anxiety disorders. In addition, the methodologic issues, possible mechanisms, and implications of comorbidity are discussed. Finally, recommendations are made for future studies to address the gaps identified in this article.

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Address reprint requests to Kathleen R. Merikangas, PhD, Department of Epidemiology, Genetic Epidemiology Research Unit, Yale University School of Medicine, 40 Temple Street, Suite 7B, New Haven, CT 06510

This work was supported in part by grants AA07080, DA05348, and MH36197 from Alcohol, Drug Abuse and the Mental Health Administration of the United States Public Health Services and a Research Scientist Development Award from the National Institute of Mental Health (KO2 MH00499 and K02DA00293) and a gift from Abbott Laboratories.