Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. The survey prompted 302 healthcare professionals who treat neurological diseases and 1100 individuals with migraine who also identify as having a mental health condition to share their opinions on migraine and its relationship to mental health. Among the participants, 92% of health care professionals and 84% of individuals with migraine reported that they believe worsening migraine can lead to a decline in mental health. Similarly, 94% of health care professionals and 87% of individuals with migraine reported that they believe better migraine control could result in better mental health. Most (91%) health care professionals and two-thirds (67%) of individuals with migraine reported that they believe those who can manage their stress and mental health conditions successfully are also better able to manage migraine.
The survey touched on conversations surrounding migraine. Although two-thirds of individuals with migraine said they believe it is important to discuss mental health with the healthcare professionals who are treating their migraines, 77% of them said they are hesitant to discuss their migraines with healthcare professionals due to stigma surrounding migraines and mental health. Almost 60% said they would raise the topic themselves but would prefer that their health care professional would initiate the conversation. However, 70% of healthcare professionals reported that they ask patients about their mental health always or often. The survey also addressed current and preferred treatment approaches.
The top three most recommended mental health treatments among healthcare professionals were medication (83%), cognitive behavioural therapy or psychotherapy (71%), and relaxation therapy (70%). However, fewer individuals with migraine report using these techniques: 58%, 28%, and 26%, respectively. Most (91%) healthcare professionals and more than half (54%) of individuals with migraine said they believe migraine management should be more flexible and tailored to individual patient needs. Finally, nearly all individuals with migraine said they think it is equally important to treat migraine and mental health and would like their treatment plan to factor in both priorities.
“Closing the gaps in communication between healthcare professionals and their patients can help improve migraine and mental health management,” said Dr Larry Newman, professor of neurology at NYU Grossman School of Medicine and chair of the American Migraine Foundation. These are important conversations that both people with migraine and healthcare professionals should initiate at every visit.”
Minen et al (2016) provided an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder, bipolar disorder, attention deficit hyperactivity disorder, sleep disorders and substance abuse.
Psychiatric comorbidities have a much higher prevalence in patients with migraine than in the general population. Of concern, psychiatric comorbidities seem to increase the risk of development of migraine chronicity, decrease the quality of life of patients with migraine, and complicate migraine management. Since psychiatric comorbidities so intricately affect migraines, their chronicity and their management, it is essential to screen patients with migraine for psychiatric comorbidities.