title: Migraine comorbidity constellations.
abstract: OBJECTIVE
  To identify distinct constellations of comorbid disorders occurring in migraineurs, and to examine differences in demographics, headache profiles, and psychosocial features between the comorbidity constellations.
  
  
  METHODS
  This is a retrospective electronic chart review of consecutive new female outpatients diagnosed with migraine (n = 223) using International Classification of Headache Disorders (ICHD)-II criteria. Questionnaire collected information on comorbid diagnoses, current depression, somatic symptoms, psychosocial stressors, and antidepressant use, social and abuse history. Cluster analysis, based on nonheadache disorders, was performed and differences between the resulting groups were examined.
  
  
  RESULTS
  We identified 3 groups. Group 1 (n = 55) was defined by hypertension, hyperlipidemia, diabetes mellitus, and hypothyroidism; Group 2 (n = 83) by depression, anxiety, and fibromyalgia; Group 3 (n = 85) by the absence of defining comorbidities. Group 1 had more males (22% vs 5% vs 12%, P < .05), was older (median years: 52 vs 36 vs 32, P < .01), and had later age of headache onset (median years: 22 vs 16 vs 18, P < .05). Group 2 had the greatest disability (P < .05), and the lowest quality of life (P < .001). Persons in Group 2 more commonly reported sexual abuse (OR = 2.7, 95% CI: 1.1 to 6.5), physical abuse (OR = 2.5, 95% CI: 1.2 to 5.1), and emotional abuse (OR = 4.3, 95% CI: 1.9 to 8.9).
  
  
  CONCLUSIONS
  Within a headache clinic population, we identified 3 different migraine comorbidity constellations, with differing headache and psychosocial profiles, suggesting heterogeneity of genetic and environmental factors. This may have implications for diagnosis and disease management.
authors.affiliation: Department of Neurology, The University of Toledo College of Medicine, Toledo, OH 43614, USA.
authors.forename: Gretchen E
authors.initials: GE
authors.lastname: Tietjen
authors.forename: Nabeel A
authors.initials: NA
authors.lastname: Herial
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hardgrove
authors.forename: Christine
authors.initials: C
authors.lastname: Utley
authors.forename: Leah
authors.initials: L
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016000:Cluster Analysis; D015897:Comorbidity; D018856:Cystitis, Interstitial / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D011584:Psychology; D011788:Quality of Life; D012189:Retrospective Studies; D012742:Sex Offenses / Q000706:statistics & numerical data; D013575:Syncope / Q000453:epidemiology