As researchers investigate the connection between Migraine disease and other conditions, we’re learning that there are connections between Migraine and other conditions – conditions that are invisible, about which there remain many myths and misconceptions, and conditions that are even more difficult for us because those around us often don’t understand them.
“…Painful conditions like Migraine and arthritis could increase a patient’s anxiety about the pain, or panic attacks may be mistaken for asthma attacks… Physicians are becoming more aware of the importance of recognizing and treating depression… Our study shows that Migraine is also very common and that similar efforts are warranted.” ~Dr. Jitender Sareen
We’ve already learned that while major depressive disorder affects 17 percent of the general population, it affects 47 percent of Migraineurs.
We recently learned that people with bipolar disorder have a significantly higher prevalence of Migraine when compared to the general population. There is also evidence of comorbidity of depressive and Migraine disorders in chronic daily headache, and its subtypes including some types of Migraine.
A new article published in the Archives of Internal Medicine reports on a study that investigated the connection between Migraine disorders and physical disorders as well as the impact of that connection.
“The negative impact of comorbidity of depression with physical illness has been well documented, and evidence has been emerging to show that Migraine disorders are associated with several physical health problems…”
There is a growing body of evidence that Migraine disorders are often comorbid with physical disorders, but there have been limitations to previous studies because of potential sample bias and patient assessment having been performed by lay interviewers rather than mental health professionals. To avoid such limitations, Sareen et al used the German Health Survey (GHS) to study the relationship between Migraine disorders and physical disorders. The GHS was the first study to assign Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses using the Composite International Diagnostic Interview, said diagnoses assigned by physicians based on interview, physical examination, and laboratory assessment.
- To examine “whether there were unique associations between the presence of an Migraine disorder with particular physical conditions.”
- To examine “whether the comorbidity of Migraine and physical health problems was independently associated with poor quality of life and disability even after adjusting for potential confounding factors (e.g., overall burden of physical illness).”
The GHS assessed physical conditions based on a combination of three methods:
- a self-report questionnaire, which asked about the presence of 44 physical conditions
- a standardized computer-assisted medical interview by a general practice physician
- blood pressure measurements and analysis of blood and urine samples.
Physical conditions were included only if there was previous empirical evidence of an association between Migraine disorders and the physical condition was prevalent enough to be included.
After Sareen et al adjusted for sociodemographic factors and other common psychological disorders, an Migraine disorder was significantly associated with:
- gastrointestinal disease
- Migraine disease
- respiratory disease
- thyroid disease
“In conclusion, the current study demonstrated that Migraine disorders are uniquely associated with several physical health conditions in the community, and this comorbidity is itself associated with poorer functional outcomes. In combination with recent data demonstrating that Migraine disorders are risk factors for suicidal behavior, the current study suggests that Migraine disorders should be considered an important public health problem in the community. During the last decade, efforts have been substantially increased to improve recognition and treatment of depression in general practice. Similar efforts should be strongly considered for Migraine disorders.”
Jitender Sareen, BSc, MD, FRCPC; Frank Jacobi, PhD; Brian J. Cox, PhD; Shay-Lee Belik, BSc(Hons) ; Ian Clara, MA; Murray B. Stein, MD, MPH . “Disability and Poor Quality of Life Associated With Comorbid Migraine Disorders and Physical Conditions.” Arch Intern Med. 2006;166:2109-2116.
Gale, Karla. “Comorbid Migraine Disorders Worsen Effects of Physical Diseases.” Reuters Health Information. October 24, 2006.
© Teri Robert, 2007.
Last updated November 14, 2007.
Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation’s Patient Partners Award and a Distinguished Service Award from the American Headache Society. Teri can be found on her website, and blog, Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.