Revisiting the bipolar disorder with migraine phenotype: Clinical features and comorbidity.
Revisiting the bipolar disorder with migraine phenotype: Clinical features and comorbidity.
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重新审视具有偏头痛表型的双相情感障碍：临床特征和合并症。
DOI：
10.1016/j.jad.2021.08.026
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发表时间：
2021
影响因子：
6.6
通讯作者：
Biernacka
中科院分区：
文献类型：
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作者：
Romo-Nava,Francisco;Blom,Thomas;Cuellar-Barboza,AlfredoB;Awosika,OluwoleO;Martens,BrianE;Mori,NicoleN;Colby,ColinL;Prieto,MiguelL;Veldic,Marin;Singh,Balwinder;Gardea-Resendez,Manuel;Nunez,NicolasA;Ozerdem,Aysegul;Biernacka
前言：评估双相情感障碍（BD）患者终生偏头痛的患病率和临床相关因素。方法在一项横断面研究中，我们评估了来自梅奥诊所双相情感障碍生物库的721名成年双相情感障碍患者，并比较了有和没有偏头痛病史的患者的临床相关性。采用结构化临床访谈（DSM-IV）和临床评估问卷来确定双相障碍诊断、偏头痛的终生病史和临床相关因素。结果277例（29%）双相障碍患者有偏头痛病史。与无偏头痛患者相比，伴有偏头痛的BD患者更年轻，女性更容易出现（p值<0.01）。在多因素logistic回归模型中，较年轻的年龄（OR=0.98, p<0.01）、女性（OR=2.02, p<0.01）、较高的体型/体重担忧（OR=1.04, p=0.02）、较高的焦虑障碍共病（OR=1.24, p<0.01）和夜间睡眠类型（OR=1.65, p=0.03）与偏头痛相关。在每个一般医疗合并症的单独回归模型中（控制年龄、性别和部位），偏头痛与纤维肌痛（OR=3.17, p<0.01）、牛皮癣（OR=2.65, p=0.03）和哮喘（OR=2.0, p<0.01）显著相关。与没有偏头痛的参与者相比，偏头痛患者接受ADHD药物（OR=1.53, p=0.05）或与减肥相关的化合物（OR=1.53, p=0.02）的比例更高。研究设计排除了因果关系的确定。没有评估偏头痛的亚型和特征。结论：偏头痛在双相障碍患者中患病率较高，且与更严重的临床负担相关，包括伴随疼痛和炎症的并发症增加。对bd -偏头痛表型的进一步研究可能提供对共同潜在神经生物学机制的见解。
IntroductionTo evaluate the prevalence and clinical correlates of lifetime migraine among patients with bipolar disorder (BD).MethodsIn a cross-sectional study, we evaluated 721 adults with BD from the Mayo Clinic Bipolar Disorder Biobank and compared clinical correlates of those with and without a lifetime history of migraine. A structured clinical interview (DSM-IV) and a clinician-assessed questionnaire were utilized to establish a BD diagnosis, lifetime history of migraine, and clinical correlates.ResultsTwo hundred and seven (29%) BD patients had a lifetime history of migraine. BD patients with migraine were younger and more likely to be female as compared to those without migraine (p values <0.01). In a multivariate logistic regression model, younger age (OR=0.98, p<0.01), female sex (OR=2.02, p<0.01), higher shape/weight concern (OR=1.04, p=0.02), greater anxiety disorder comorbidities (OR=1.24, p<0.01), and evening chronotype (OR=1.65, p=0.03) were associated with migraine. In separate regression models for each general medical comorbidity (controlled for age, sex, and site), migraines were significantly associated with fibromyalgia (OR=3.17, p<0.01), psoriasis (OR=2.65, p=0.03), and asthma (OR=2.0, p<0.01). Participants with migraine were receiving ADHD medication (OR=1.53, p=0.05) or compounds associated with weight loss (OR=1.53, p=0.02) at higher rates compared to those without migraine.LimitationsStudy design precludes determination of causality. Migraine subtypes and features were not assessed.ConclusionsMigraine prevalence is high in BD and is associated with a more severe clinical burden that includes increased comorbidity with pain and inflammatory conditions. Further study of the BD-migraine phenotype may provide insight into common underlying neurobiological mechanisms.