Migraine and psychiatric comorbidity: a review of clinical findings.
Migraine and psychiatric comorbidity: a review of clinical findings.
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DOI：
10.1007/s10194-010-0282-4
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发表时间：
2011-04
影响因子：
7.4
通讯作者：
Costa, Alfredo
中科院分区：
文献类型：
--
作者：
Antonaci, Fabio;Nappi, Giuseppe;Galli, Federica;Manzoni, Gian Camillo;Calabresi, Paolo;Costa, Alfredo
偏头痛是一种非常常见的疾病。这种慢性疾病与急性症状交织的潜在机制似乎越来越复杂。偏头痛异质性的一个重要方面是与其他神经系统疾病、心血管疾病和精神疾病共病。据世卫组织估计，抑郁症是全世界残疾的主要原因之一。在这篇综述中，我们主要考虑了一般人群研究和成人和儿童临床样本研究的结果，重点是偏头痛和精神疾病（DSM轴I）之间的关联，在IHS（1988）的第一次分类之后进行。虽然由于诊断方法的差异而不易比较，但一般人群研究通常表明，与非偏头痛受试者相比，偏头痛患者的情感和焦虑障碍风险增加。偏头痛与双相情感障碍也有关联的趋势，但与药物滥用/依赖无关。对于偏头痛亚型，合并症主要涉及有先兆的偏头痛。然而，与每日慢性头痛的患者相比，患有偏头痛的患者显示出发展情感和焦虑障碍的风险降低。此外，慢性头痛和药物使用患者的精神障碍似乎比单纯性偏头痛患者更常见。偏头痛精神共病的潜在机制目前知之甚少，但这一主题仍然是未来研究的优先事项。精神共病确实影响偏头痛的演变，可能导致慢性物质使用，并可能改变治疗策略，最终改变这种重要疾病的结果。
Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.
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