Adolescents With Migraine More Likely to Develop Other Disorders, Study Says

Adolescents with a migraine diagnosis are more than twice as likely to develop additional psychiatric or pain disorders compared with adolescents without a migraine diagnosis, according to a study published in Cephalalgia.

This is the first study to show that adolescents diagnosed with migraine are at a significantly higher risk for developing an additional, comorbid disorder over the next 10 years in their transition into adulthood, compared to adolescents without any headache diagnosis.

Currently, the global prevalence of headache disorders is 46% in adults and 58% in children.

The study used BARMER health insurance data of 56,597 German adolescents that were 15 years old in 2006 to learn whether adolescents diagnosed with migraine are at significantly higher risk of developing other psychiatric comorbidities and pain syndromes during a 10-year time span. compared with adolescents without a headache diagnosis. All diagnoses were based on International Classification of Diseases (ICD) 10.

The following comorbidities were evaluated in the study:

• Mood disorders
• Neurotic, stress-related, and somatoform disorders
• Behavioral syndromes associated with physiological disturbances and physical factors
• Back pain
• Irritable bowel syndrome

Patients that were diagnosed with headache but not migraine and patients already diagnosed with any of these 5 comorbidities in 2006 were excluded from the final study. The control group included 22,368 patients without a migraine diagnosis and the test group included 431 patients with a consistent migraine diagnosis.

In the 10-year follow-up period, researchers found that adolescent patients with a migraine diagnosis had a higher risk of developing the following additional disorders:

• 2.1 times more likely to develop additional affective or mood disorders
• 1.8 times more likely to develop neurotic, stress-related, and somatoform disorders
• 1.8 times more likely to develop behavioral syndromes
• 1.6 times more likely to develop back pain
• 1.5 times more likely to develop irritable bowel syndrome

Research showed that 88.4% of the patients with migraine developed at least 1 of these disorders between 2006 and 2016. Overall analysis showed that patients in this group were 1.3 times more likely to develop 1 or more of the evaluated additional disorders compared to patients without a migraine diagnosis.

For clinical care, this study demonstrates the importance of considering the risk of later additional disorders in the initial medical assessment and during the clinical course of migraine in young patients.

“This vulnerability of adolescent patients with migraine contributes to the idea that migraine is a brain state with underlying alterations in the activity of multiple brain networks,” the authors said. “The question if migraine as a brain state constitutes a specific risk factor for additional psychological disorders or if chronic pain nonspecifically leads to a higher vulnerability for later disorders is not yet answered.”

They also suggest this increased risk may also increase the impact of migraine on an individual’s well-being, saying early evaluation of risks for additional disorders is essential in the care of these patients.

“Especially the transition from childhood to adulthood seems to be a vulnerable phase for this aspect and requires an increased awareness,” the authors concluded.

Reference

Gerstl L, Tadych N, Heinen F, et al. Migraine and the development of additional psychiatric and pain disorders in the transition from adolescence to adulthood. Cephalalgia. Published online June 23, 2021. doi:10.1177/03331024211021792