Migraine comorbidity constellations.
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.
Tietjen
Gretchen E
GE
Department of Neurology, The University of Toledo College of Medicine, Toledo, OH 43614, USA.
Herial
Nabeel A
NA
Hardgrove
Jacqueline
J
Utley
Christine
C
White
Leah
L
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