title: Rapid cycling as a feature of bipolar disorder and comorbid migraine.
abstract: BACKGROUND
  Previous research has suggested the clinical profile of individuals with bipolar disorder (BD) differs according to the presence or absence of comorbid migraine. We aimed to determine the clinical characteristics that differentiate individuals with BD with and without comorbid migraine in a large, representative, clinically well-characterised UK sample.
  
  
  METHODS
  The lifetime clinical characteristics of 1488 individuals with BD (BPI n=1120, BPII n=368) with and without comorbid migraine were compared (n=375 vs. n=1113 respectively).
  
  
  RESULTS
  Individuals with BD and comorbid migraine had a distinctive set of lifetime clinical characteristics. A multivariate model showed that consistent with previous studies those with comorbid migraine were significantly more likely to be female (OR=2.099, p=0.005) and have comorbid panic attacks (OR=1.842, p=0.004). A novel finding was that even after controlling for other differences, the individuals with BD and comorbid migraine were more likely to have a rapid cycling illness course (OR=1.888, p=0.002).
  
  
  CONCLUSIONS
  Presence of migraine was assessed using self report measures. Cross-sectional study design limits investigations of bidirectional associations between migraine and bipolar disorder.
  
  
  CONCLUSIONS
  Comorbid migraine in BD may represent a more homogenous subtype of BD with an unstable rapid cycling course. Identifying individuals with BD and comorbid migraine may be of use in a clinical setting and this subgroup could be the focus of future aetiological studies.
authors: Institute of Psychological Medicine & Clinical Neurosciences, Cardiff University, UK; Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, UK; Bipolar Disorder Research Network (BDRN, bdrn.org), UK.
authors: K
authors: K
authors: Gordon-Smith
authors: Institute of Psychological Medicine & Clinical Neurosciences, Cardiff University, UK; Bipolar Disorder Research Network (BDRN, bdrn.org), UK.
authors: L
authors: L
authors: Forty
authors: Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, UK.
authors: C
authors: C
authors: Chan
authors: Institute of Psychological Medicine & Clinical Neurosciences, Cardiff University, UK; Bipolar Disorder Research Network (BDRN, bdrn.org), UK.
authors: S
authors: S
authors: Knott
authors: Institute of Psychological Medicine & Clinical Neurosciences, Cardiff University, UK; Bipolar Disorder Research Network (BDRN, bdrn.org), UK.
authors: I
authors: I
authors: Jones
authors: Institute of Psychological Medicine & Clinical Neurosciences, Cardiff University, UK; Bipolar Disorder Research Network (BDRN, bdrn.org), UK.
authors: N
authors: N
authors: Craddock
authors: Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, UK; Bipolar Disorder Research Network (BDRN, bdrn.org), UK. Electronic address: l.a.jones@bham.ac.uk.
authors: L A
authors: LA
authors: Jones
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000453:epidemiology*; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D016584:Panic Disorder / Q000453:epidemiology*; D057566:Self Report; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Bipolar disorder; Comorbidity; Migraine; Rapid cycling