Two studies appearing in last month's edition of the journal Headache examine the link between migraine headaches and mental health conditions. Migraines occur in roughly 11 percent of the population, and can include many ancillary symptoms including nausea and sensitivity to light. The headaches tend to afflict women more often than men, and doctors still remain unsure of what causes migraines and why some stimuli act as "triggers."
In one of the studies, conducted by Dr. Nathalie Jette of the University of Calgary, migraine sufferers were assessed for prevalence of mental health conditions using data from a 2002 survey of Canadian citizens. Within the cohort of 36,984 respondents, Dr. Jette found that 15.6 percent of women and 6.1 percent of men experienced migraines. These individuals were more than twice as likely to suffer from major depression, bipolar disorder, and social phobia than were non-migraines sufferers. Interestingly, substance dependence was not found to occur any more frequently among the migraine group than among the non-migraine group. Migraine sufferers who also qualified for a mental health diagnosis did poorly on all measures of health-related outcomes measured by the survey. Sufferers of both had higher levels of 2-week disability, restriction of abilities, quality of life, and utilization of health care than respondents who qualified for only one of the two diagnoses.
The second study was conducted by Drexel University's Dr. Lee Peterlin and a team of headache researchers. This group looked specifically at post-traumatic stress disorder (PTSD) and its potential interaction with or relation to migraines. Dr. Peterlin looked at a much smaller group of individuals who had sought out treatment at a headache center. Of this group of 60, roughly half were diagnosed with chronic migraines, while the other half were diagnosed with episodic migraines. In conducting thorough interviews with each individual, researchers were able to determine that depression was far more common in the chronic sufferers (55.2 to 21.9 percent). Similarly, while both groups had equal rates of traumatic event experiences in their life, the chronic group was far more likely to have dealt with PTSD (42.9 to 9.4 percent). This difference remained significant even when potential confounding factors were controlled for.
Because of the nature of the relationship between PTSD and migraines that they observed, Dr. Peterlin and his team speculate that PTSD may be a factor in turning episodic migraine sufferers into chronic sufferers. Their study was small though, and a larger, preferably longitudinal, study will be necessary before any of this speculations can be addressed. In both this study and the broader look at mental health done by Dr. Jette, migraines were found to correlate with mental health problems. This correlation can make both conditions more difficult to handle, and thus lead to poorer outcomes. Doctors treating for either migraines or mental health conditions would help their clients by assessing the risks of the other condition. In some cases, therapy might prove beneficial for migraine sufferers, and in either case, medications should be monitored to ensure that potentially harmful interactions or side-effects are avoided.
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