title: Influence of psychiatric comorbidities in migraineurs in the emergency department.
abstract: OBJECTIVE
  To examine how psychiatric comorbidities in migraineurs in the emergency department (ED) affect healthcare utilization and treatment tendencies.
  
  
  METHODS
  This is a cross-sectional analysis of 2872 patients who visited our ED over a 10-year period and were given a principal diagnosis of migraine.
  
  
  RESULTS
  Compared to migraineurs without a psychiatric comorbidity, migraineurs with a psychiatric comorbidity had about three times more ED visits, six times more inpatient hospital stays and four times more outpatient visits. Migraineurs with psychiatric comorbidities received narcotics in the ED more often than migraineurs without psychiatric comorbidities (P<0.0001). In addition, migraineurs with psychiatric disorders were more likely to have a computed tomography scan of the head [Risk Ratio (RR) 1.42 (95% confidence interval (CI)=1.28-1.56, P<0.001)] or a magnetic resonance image of the brain [RR 1.53 (95% CI=1.33-1.76, P<0.001)] than patients without a psychiatric disorder when visiting our hospital center.
  
  
  CONCLUSIONS
  Migraineurs with psychiatric comorbidity who visit the ED have different healthcare utilization tendencies than migraineurs without psychiatric comorbidity who visit the ED. This is seen in the frequency of ED visits, outpatient visits and inpatient stays, in the medications administered to them and in the radiology tests they undergo.
authors.affiliation: Graham Headache Center, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: MinenMD@gmail.com.
authors.forename: Mia T
authors.initials: MT
authors.lastname: Minen
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Kaloyan
authors.initials: K
authors.lastname: Tanev
mesh_terms: D000328:Adult; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology* / Q000628:therapy; D012042:Registries / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Emergency department; Healthcare utilization; Migraine; Narcotics; Psychiatric