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Cited by 116Migraine and Headache StudiesTraumatic Brain Injury ResearchPsychosomatic Disorders and Their Treatments

Migraine and psychiatric comorbidity: From theory and hypotheses to clinical application

Sheftell, Fred D., Atlas, Susan J.·2002·Headache The Journal of Head and Face Pain
DOI 10.1046/j.1526-4610.2002.02217.x
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Abstract

OBJECTIVE: To review psychiatric issues that accompany migraine and means of addressing these issues. BACKGROUND: Psychiatric factors and migraine may interact in three general ways, etiologically, psychophysiologically or biobehaviorally, and comorbidly (the two disorders coexist), which is the present focus. There are several possible mechanisms of comorbidity. The relation between two disorders may be a result of chance. One disorder can cause another disorder: Diabetes can cause diabetic neuropathy. There might be shared environmental risks: Head trauma can cause both posttraumatic epilepsy and posttraumatic headache. And there may be environmental or genetic risk factors that produce a brain state giving rise to both conditions, that is, there may be some common biology underlying both conditions. This last mechanism seems to be the most likely one underlying comorbidity of migraine and psychiatric disorders. We introduce a possible role for classical paradigms of learned helplessness in regard to psychiatric comorbid depressive and anxiety disorders and migraine. RESULTS: There appears to be an association between migraine and affective disorders, particularly depression and anxiety. There are a number of formal tools for recognizing depression, but clinical evaluation should not be overlooked. Once diagnosed, depression and anxiety should be treated, both to improve the success of migraine treatment and to improve the patient's quality of life. Patients with recurring headaches are much more likely to overuse and misuse, rather than abuse, pain medications. It is important to be alert for signs that the patient may be misusing medication. Behavioral approaches can surround and support pharmacological therapy. CONCLUSIONS: Migraine is often comorbid with psychiatric disorders, particularly depression and anxiety. The relationship is likely based on shared mechanisms and successful treatment is possible.

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  • In the general population, depression is associated with a wide range of health, mental health, and neurological conditions, such as chronic pain, headaches and migraines, diabetes, low testosterone, cardiovascular/cerebrovascular/small vessel ischemic disease, PD, MCI, and AD.

    “In the general population, depression is associated with a wide range of health, mental health, and neurological conditions, such as 1) chronic pain [71–75]; 2) headaches and migraines [76–79]; 3) diabetes [80–82]; 4) low testosterone [83–85]; 5) cardiovascular, cerebrovascular, and small vessel ischemic disease [86–92]; 6) PD [93]; 7) MCI [94–96]; and 8) AD [97].”

    From The Need to Separate Chronic Traumatic Encephalopathy Neuropathology from Clinical Features (2017) · cites this paper as [79]

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Authors
Sheftell, F. D., & Atlas, S. J.
Affiliations
New England Institute for Neurology and Headache (US)
Corresponding author
Sheftell, Fred D.
Venue
Headache The Journal of Head and Face Pain
Publisher
Wiley
Published
2002-10
Volume
42
Issue
9
Pages
934-944
ISSN
  • 0017-8748 (ISSN-L)
  • 1526-4610
DOI
10.1046/j.1526-4610.2002.02217.x
OpenAlex
W1995324716
Cited by
116
References
48
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 5 · 2016: 5 · 2015: 2 · 2014: 5 · 2013: 7 · 2012: 5
FWCI
4.92
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 24 d)
Locations
  • Headache The Journal of Head and Face Pain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
migraine, psychiatric comorbidity, depression, anxiety disorders, learned helplessness, medication overuse headache, behavior therapy, quality of life
MeSH terms
Anxiety Disorders, Mental Disorders, Behavioral Medicine, Depressive Disorder, Humans, Migraine Disorders, Substance-Related Disorders

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