Significant correlations identified between mental health and migraine

Recently announced results from the Migraine and Mental Health Connection Survey showed that a majority of healthcare professionals and migraine patients believe that migraine and mental health have a significant impact on each other. , adding that stigma remains a major issue for patients seeking to discuss their mental state further.1

The study, a collaborative effort between the American Migraine Foundation and Biohaven Pharmaceuticals, gathered responses from 1,100 people with migraine and a mental health condition, and 302 medical professionals who treat neurological conditions. The results showed that 91% of healthcare professionals and two-thirds (67%) of migraine patients believed that better migraine management was associated with better overall stress control and mental health.

“Migraine is complex and has the ability to disrupt a person’s life, relationships, and sense of well-being, which in turn can impact their mental health,” said Judy Ho, PhD, forensic neuropsychologist and associate professor at Pepperdine University. statement.1 “The Investigating the links between migraine and mental health showed that migraine sufferers and healthcare professionals agree that the unpredictable and debilitating nature of migraine attacks often creates worry and anxiety that can complicate migraine management and have a further impact on their mental health.

She added: “It’s what is often called a ‘vicious circle’ between migraine and mental health. It is important for migraine sufferers to understand that improving mental health can lead to better migraine outcomes, and vice versa.

While two-thirds of patients thought it was important to discuss mental health with their healthcare professional, 60% of patients initiated the conversation themselves, although most wanted their healthcare professional to initiate the conversation. conversation. Contrary to these ideas, 70% of healthcare professionals said they ask about mental health issues frequently, if not always. The results also suggest that medical professionals underestimate the number of migraine patients who suffer from anxiety or depression. Although 50% and 57% reported a diagnosis of an anxiety or depressive disorder, medical professionals estimated that these conditions occur in only 29% and 30% of patients, respectively.

In a conversation with NeurologyLive®, Larry Newman, MD, professor of neurology, NYU Grossman School of Medicine and president of the AMF, noted that some of the discrepancies in mental health conversations could be driven by hesitation around which specialist – migraine or mental health – is optimal for talking about these issues. “I was struggling with that looking at the results. I think the patient is very savvy and they know they’re going to see a doctor and the doctor is going to give them 15 minutes. do I get the most out of this visit? If I take a tangent, will I not get the treatment I need for my migraine? Or, if I take another tangent, will I not get care for my sanity. They’re playing this game, and they’re pretty much stuck between a rock and a hard place. In many cases, they want help, but they don’t know where to go,” a- he explained.

Newman added that as a headache specialist, he has a luxury of time for patient visits that other physicians who treat migraine patients may not have. For clinicians who have it, giving these people time to discuss their mental health can be an important part of uncovering the challenges they face. “Part of this is because the patient relaxes when proactively asked about their anxiety or depression. It’s like that light bulb goes off when you tell them, “I’m not surprised you have depression” or “I’m not so surprised you also have an anxiety disorder.” Because they are comorbid, they go together more often than you might think by chance. It kind of allows them to sit back, relax, and realize that I’m not just here to get three things, write a prescription, and get them out,” he said. NeurologyLive®.

The overwhelming majority of migraine patients (87%) and healthcare professionals (94%) said mental health would benefit from better migraine control. Medication (83%), followed by psychotherapy or cognitive behavioral therapy (71%) and sophrology (70%) were the main mental health treatments recommended by health professionals. Despite these recommendations, only 58%, 28%, and 26% of patients reported using the techniques as frequently, respectively. Almost all healthcare professionals (91%) and more than half of migraine patients (54%) felt migraine management needed to be more flexible in tailoring treatment to patient needs.

“Closing gaps in communication between healthcare professionals and their patients can help improve migraine and mental health management,” Newman said in a statement.1 “I hope the results of this survey will encourage migraine sufferers to feel empowered to talk about their pain and have deeper, meaningful conversations about migraine and mental health without worrying about stigma. These are important conversations that migraine sufferers and healthcare professionals should start at every visit.”

The link between migraine and mental health has been documented before, even in pediatric populations. Results from the Canadian Community Health Survey, a cross-sectional health survey of 61,375 participants, further explain this link.2 According to the Composite International Diagnostic Interview-Short Form Depression Scale, the risk of migraine were higher in people with mood disorders, with the strongest association in 2011-2012 (adjusted odds ratio [aOR], 4.59; 95% CI, 3.44-6.12) and the lowest in 2009-2010 (ORa, 3.06; 95% CI, 2.06-4.55). The inverse association between high perceived mental health and the likelihood of migraine was observed across all cycles, with the strongest association in 2011-2012 (aOR, 0.58; 95% CI, 0.48- 0.69) and lowest in 2003-2004 (aOR, 0.75; 95% CI, 0.62-0.91).2

This study was led by Serena L. Orr, who recently appeared as a special guest on a NeurologyLive® Mind Moments podcast to discuss more recent work she has done on mental health issues in pediatric migraine patients. Click on the link below to hear the pediatric neurologist and headache specialist from the University of Calgary and Alberta Children’s Hospital provide additional information on how the field has progressed in managing the disease and defense of these people.

REFERENCES
1. A survey by the American Migraine Foundation shows that almost all migraine sufferers and healthcare professionals believe that migraine and mental health have a significant impact on each other. Press release. July 28, 2022. Accessed August 1, 2022. https://www.prnewswire.com/news-releases/american-migraine-foundation-survey-shows-nearly-all-people-with-migraine-and-healthcare-professionals – believe-that-migraine-and-mental-health-have-a-significant-impact-on-each-other-301594846.html
2. Orr SL, Potter BK, Ma J, Colman I. Migraine and mental health in a population-based sample of adolescents. Can J Neurol Sci. 2017;44(1):44-50. Doi: 10.1017/cjn.2016.402.