Opinion of...

Migraine and psychiatric comorbidity

Maria Pia Prudenzano - Centro Cefalee, Clinica Neurologica “L. Amaducci”. Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso. Università di Bari

Migraine affects about 12% of individuals in the general population. Although it may occur at all ages, its prevalence is lower in children and the elderly, reaching a peak in the 25- to 39-year-old age range that corresponds to that of maximum productivity (1). After menarche, there is a much higher prevalence in women than in men.

Global Burden of Diseases places migraine among the ten most disabling neurological pathologies in the world population and in first place as a cause of disability below the age of 50 (2).

The social impact of this pathology is high both in terms of direct costs, due to diagnostic investigations and treatment, and indirect costs, which are far more burdensome and derive from the loss of work days and productivity (3).

The psychopathological aspects of migraine have long been a research topic of great interest. In the 1950s, Wolff identified a distinctive personality pattern and described the migraine patient, especially if a woman, as a subject prone to perfectionism and neuroticism (4).

In more recent times, results of numerous epidemiological studies, among which the studies of Breslau and Merikangas represent true milestones, show that migraineurs have a 2 to 4 times greater risk of depression than non-migraineurs (5,6,7).

The association between depression and migraine appears stronger in the form with aura than that without aura. In patients with migraine-associated depression, the symptoms of the migraine attack, including osmophobia and allodynia, are positively correlated with the...

Read more »