Risk of Developing Migraine among Patients with Posttraumatic Stress Disorder: A Nationwide Longitudinal Study

Mao-Hsuan Huang ； Yee-Lam E. Chan ； Ju-Wei Hsu ； Ya-Mei Bai ； Kai-Lin Huang ； Shih-Jen Tsai ； Tung-Ping Su ； Cheng-Ta Li ； Wei-Chen Lin ； Tzeng-Ji Chen ； Mu-Hong Chen

《台灣精神醫學》 33卷4期 (2019/12) Pp. 192-197

https://doi.org/10.4103/TPSY.TPSY_40_19

摘要

Objective: We intended to investigate the risk of developing migraine among patients with posttraumatic stress disorder (PTSD). Methods: With the Taiwan's National Health Insurance Research Database, we examined 5,644 patients with PTSD and 22,576 age- and sex-matched controls between 2002 and 2009 and followed them to the end of 2011. Individuals who developed migraine during the follow-up period were identified. Results: Patients with PTSD had a significantly higher incidence of developing migraine (5.74 vs. 1.22 per 1,000 person-years, p ＜ 0.001) during the follow-up period than the controls. We did Cox regression analysis with adjustments of demographic data and medical comorbidities and found that patients with PTSD were more likely to develop migraine (hazard ratio [HR] = 3.83, 95% confidence interval [CI] = 2.82-5.20) than the control group. Sensitivity analyses after excluding the 1st year (HR = 2.89; 95% CI = 2.04-4.08) or the first 3 years (HR = 2.07; 95% CI = 1.32-3.24) of observation showed consistent findings. Moreover, a high frequency of psychiatric clinics visiting for PTSD was associated with an increased risk of developing migraine. Conclusion: Patients with PTSD had a higher risk of migraine than the controls. The symptom severity of PTSD may be associated with an increased risk of migraine. Further studies are required to investigate the underlying pathophysiology between PTSD and migraine.

關鍵字

comorbidities ； headache ； survival curve ； Taiwan's National Health Insurance Research Database

參考文獻

Bigal ME, Liberman JN, Lipton RB: Age-dependent prevalence and clinical features of migraine. Neurology 2006; 67: 246-51.

Scher AI, Stewart WF, Ricci JA, Lipton RB: Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain 2003; 106: 81-9.

Vetvik KG, MacGregor EA: Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol 2017; 16: 76-87.

Peterlin BL, Ward TN: Neuropsychiatric aspects of migraine. Curr Psychiatry Rep 2005; 7: 371-5.

Chen MH, Hsu JW, Huang KL, et al.: Migraine comorbidity and subsequent diagnostic conversion to bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study. Taiwanese J Psychiatry 2016; 30: 169-76.