TY - JOUR
T1 - Revisiting the bipolar disorder with migraine phenotype
T2 - Clinical features and comorbidity
AU - Romo-Nava, Francisco
AU - Blom, Thomas
AU - Cuellar-Barboza, Alfredo B.
AU - Awosika, Oluwole O.
AU - Martens, Brian E.
AU - Mori, Nicole N.
AU - Colby, Colin L.
AU - Prieto, Miguel L.
AU - Veldic, Marin
AU - Singh, Balwinder
AU - Gardea-Resendez, Manuel
AU - Nunez, Nicolas A.
AU - Ozerdem, Aysegul
AU - Biernacka, Joanna M.
AU - Frye, Mark A.
AU - McElroy, Susan L.
N1 - Publisher Copyright:
© 2021
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Introduction: To evaluate the prevalence and clinical correlates of lifetime migraine among patients with bipolar disorder (BD). Methods: In 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. Results: Two 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. Limitations: Study design precludes determination of causality. Migraine subtypes and features were not assessed. Conclusions: Migraine 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.
AB - Introduction: To evaluate the prevalence and clinical correlates of lifetime migraine among patients with bipolar disorder (BD). Methods: In 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. Results: Two 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. Limitations: Study design precludes determination of causality. Migraine subtypes and features were not assessed. Conclusions: Migraine 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.
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U2 - 10.1016/j.jad.2021.08.026
DO - 10.1016/j.jad.2021.08.026
M3 - Article
C2 - 34464877
AN - SCOPUS:85113789666
SN - 0165-0327
VL - 295
SP - 156
EP - 162
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -