Migraine headache and bipolar disorder comorbidity: A systematic review of the literature and clinical implications

2016 ◽  
Vol 11 (1) ◽  
pp. 136-145 ◽  
Author(s):  
Raphael J. Leo ◽  
Joshna Singh
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Migraine Headache ◽  
Unipolar Depression ◽  
Epidemiological Studies ◽  
Prevalence Rates ◽  
Review Of The Literature ◽  
Weighted Mean ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii

AbstractBackground and aimsPsychiatric disorders, e.g., depression, are often comorbid with, and can complicate the treatment of, patients with migraine headache. Although empirical work has increasingly focused on the association between migraine and bipolar disorder, this topic has received little attention in the pain literature. Bipolar disorder is a chronic and recurrent mood disorder characterized by cyclic occurrence of elevated (i.e., manic or hypomanic) and depressed mood states. Bipolar I disorder is diagnosed when patients present with at least one abnormally and persistently elevated manic episode; bipolar II disorder is characterized by the presence of hypomanic episodes. Bipolar disorder warrants attention as depressive phases of the disorder can prevail and are often misconstrued by the unwary clinician as unipolar depression. However, treatment for bipolar disorder is distinct from that of unipolar depression and use of antidepressants, which are often invoked in migraine prophylaxis as well as the treatment of depression, may precipitate significant mood changes among bipolar disorder patients. A systematic review of the literature addressing the co-occurrence of bipolar disorder and migraine was conducted. The treatment of dually affected patients is also discussed.MethodsIn order to review the literature to date on migraine and bipolar disorder co-occurrence, a comprehensive search of MEDLINE, EMBASE, PubMed, PsycINFO, Web of Science, and CINAHL for clinic-based and epidemiological studies was conducted using terms related to migraine and bipolar disorder. Studies were selected for review if they included subjects meeting validated diagnostic criteria for bipolar disorder as well as migraine headache and if a quantitative description of prevalence rates of comorbid bipolar disorder and migraine were reported. Weighted means of the prevalence rates were calculated to compare with general epidemiological prevalence trends for migraine and bipolar disorder, respectively.ResultsEleven studies met inclusion criteria. Although findings were constrained by methodological limitations and several low quality studies, clinic- and epidemiological cross-sectional investigations demonstrated a high rate of comorbidity between bipolar disorder and migraine. The weighted mean prevalence rate for migraine headache among bipolar disorder patients was 30.7%; for bipolar disorder among migraineurs, the weighted mean prevalence rates were 9% and 5.9% in clinic-based and epidemiological studies, respectively. The association between bipolar disorder and migraine was most notable among women and patients with the bipolar II disorder subtype.ConclusionsHigh rates of comorbidity exist between migraine and bipolar disorder, exceeding estimated prevalence rates for those conditions in the general population. Comorbidity may portend a more serious clinical course for dually afflicted individuals.ImplicationsClinicians need to structure treatment approaches to address concurrent migraine and bipolar disorder in dually afflicted individuals. Although further evidence-based investigation is warranted to inform optimal treatment approaches for both conditions concurrently, anticonvulsants (e.g., valproate, lamotrigine and topiramate); atypical antipsychotics (e.g., olanzapine or quetiapine); and calcium channel blockers (e.g., verapamil) may be considered.

scholarly journals Hypomanic Symptoms in Female Undergraduate Students Diagnosed with Unipolar Depression Based on Scores on the Hypomania Checklist

2009 ◽  
Vol 5 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Thomas Richardson ◽  
Hugh Garavan
Keyword(s):  
Bipolar Disorder ◽  
Undergraduate Students ◽  
Unipolar Depression ◽  
Female Undergraduate ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii

Background: A number of studies have documented high levels of hypomanic symptoms in those diagnosed with depression, suggesting a potential misdiagnosis of bipolar disorder as unipolar depression. Research suggests that undergraduate students have high levels of depression, but whether such misdiagnosis occurs in this population has not been examined. The aim of this study was therefore to examine levels of hypomania in undergraduate students reporting diagnosed depression. Methods: An international sample of undergraduate students completed the 32-item Hypomania Checklist (HCL-32). A cohort was analysed for this study, consisting of female undergraduate students reporting a formal diagnosis of depression (n=28). Results: Participants scored high on the HCL-32, with a mean total score of 19.9 (SD=5.4) out of 32. Overall, 85.7% (n=24) scored equal to or above the original cut off point of 14 suggested for bipolar II disorder. Conclusions: Two possible conclusions are suggested by this study. Firstly, there are high levels of hypomanic symptoms in undergraduate students diagnosed with depression, suggesting that a formal diagnosis of bipolar disorder should be pursued in those with high scores. Alternatively, the cut-off points previously suggested for the HCL-32 may not be accurate for use with undergraduate students.

P01-208-Prevalence of hypomania in patients with diagnosis of affective disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 209-209
Author(s):  
I. Garcia Del Castillo ◽  
L. Fernandez Mayo ◽  
R. Carmona Camacho ◽  
M.J. Martin Calvo ◽  
E. Serrano Drozdowskyj ◽  
...  
Keyword(s):  
High Sensitivity ◽  
Unipolar Depression ◽  
Epidemiological Studies ◽  
Self Report ◽  
Future Research ◽  
Control Group ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii ◽  
Dsm Iv ◽  
The Difference

IntroductionRecent epidemiological studies suggest that the prevalence of bipolar disorder might be misdiagnosed initially as unipolar depression due to the difficulty to detect episodes of hypomania. The Hypomania Checklist (HCL-32), validated in Spanish, is a self-report questionnaire with 32 hypomania items designed to screen for hypomanic episodes.ObjectivesTo examine the prevalence of hypomania in patients with unipolar depression. Corroborate the efficacy of the HCL-32 to detect symptoms of hypomania.MethodsThe presence of hypomanic symptoms was assessed by the HCL-32 in a sample of 128 subjects diagnosed with bipolar I disorder (n = 30), bipolar II disorder (n = 1), unipolar depression (n = 57), and anxiety disorder (n = 15) according to DSM-IV-TR criteria. A control group of healthy subjects was selected (n = 25).ResultsThe discriminative capacity was analyzed by the ROC curve. The AUC was 0.65 which did not indicate a good capacity. The sensitivity (S), specificity (E) and prevalence (P) of hypomania in unipolar patients for the following cut-off points were :14: S = 81.6%,95%CI(69.8, 93.5); E = 30.1%,95%CI(19.7,40.6); P = 74.1%; 15: S = 77.6%,95%CI(64.9,90.3); E = 37.4%,95%CI(26.3,48.4); P = 67.2%; 16: S = 59.2%,95%CI(44.4,73.9); E = 55.4%,95%CI(44.1,74.0); P = 51.7%; 17: S = 55.1%,95%CI(40.2,70.1); E = 57.8%,95%CI(46.6,69.1); P = 48.3%.ConclusionsThe HCL-32 has a high sensitivity but a low specificity as screening instrument. This might explain the high proportion of hypomania found in this study. The difference with previous studies is that our sample was heterogeneous, unstable and serious. This suggests that the HCL-32 is not valid for any psychiatric sample. Future research should develop more specific instruments with better external validity.

Comorbidity of bipolar disorder and bulimia nervosa

1994 ◽  
Vol 9 (6) ◽  
pp. 315-317
Author(s):  
H Verdoux ◽  
M Mury ◽  
M Bourgeois
Keyword(s):  
Bipolar Disorder ◽  
Eating Disorders ◽  
Bulimia Nervosa ◽  
Bipolar Disorders ◽  
Unipolar Depression ◽  
Epidemiological Studies ◽  
Increased Risk ◽  
Bipolar Ii

SummaryThe association of eating disorders and bipolar disorders is less documented than the well-established association of eating disorders and unipolar depression. However, epidemiological studies have demonstrated an increased risk for bipolar disorders, especially bipolar II, in bulimic patients. We report the case of a patient displaying such a morbid association.

Polarised views about bipolar disorder(s): A critique of the 2020 College guidelines for mood disorders

2021 ◽  
pp. 000486742110200
Author(s):  
Gordon Parker
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
International Classification Of Diseases ◽  
Bipolar Ii Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Bipolar Ii ◽  
Classification Of Diseases ◽  
Formal Status

The 2020 College guidelines for mood disorders banish bipolar II disorder – despite its formal status in Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases manuals for more than two decades – and argue that there is no need to partition bipolar disorder into separate sub-types. Their single-entity model is seemingly based on opinion rather than any support from referenced scientific studies. The author challenges the Committee’s model of there being only one bipolar disorder and argues that it presents several clinical management risks, particularly of ‘over-treatment’.

scholarly journals Tobacco use among the elderly: a systematic review and meta-analysis

2010 ◽  
Vol 26 (12) ◽  
pp. 2213-2233 ◽  
Author(s):  
Valeska Marinho ◽  
Jerson Laks ◽  
Evandro Silva Freire Coutinho ◽  
Sergio Luís Blay
Keyword(s):  
Systematic Review ◽  
Tobacco Use ◽  
Literature Search ◽  
Economic Status ◽  
Meta Analysis ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Elderly Subjects ◽  
Random Effects Model ◽  
Prevalence Rates

The aim of this study was to combine the results of identified surveys on the prevalence of tobacco use in old age to estimate world prevalence of tobacco use and possible factors related to such behavior among the elderly. The literature search included electronic databases such as MEDLINE, LILACS, and Biological Abstracts, hand-searching of specialist journals and cited reference searches. The combined global prevalence was estimated using the random effects model. The total number of elderly subjects included in all surveys was 140,058, with data available from all the continents. Overall prevalence of tobacco use was 13% in both genders (22% male and 8% female). The prevalence rates were heterogeneous among surveys and were associated with smoking definition, questionnaire application, and country economic status. Few epidemiological studies assessed tobacco use among the elderly. A higher prevalence rate of tobacco use in males who live in higher income countries could be found, although additional evidence regarding elderly samples is still required.

scholarly journals Comparing clinical responses and the biomarkers of BDNF and cytokines between subthreshold bipolar disorder and bipolar II disorder

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Tzu-Yun Wang ◽  
Sheng-Yu Lee ◽  
Shiou-Lan Chen ◽  
Yun-Hsuan Chang ◽  
Liang-Jen Wang ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Ii Disorder ◽  
Bipolar Ii ◽  
Clinical Responses

Bipolar disorder and stigma: A systematic review of the literature

2013 ◽  
Vol 151 (3) ◽  
pp. 805-820 ◽  
Author(s):  
Nell Ellison ◽  
Oliver Mason ◽  
Katrina Scior
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Review Of The Literature

scholarly journals The Incidence of Nonunion of the Hallux Interphalangeal Joint Arthrodesis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0038
Author(s):  
Mark Prissel ◽  
Eric So ◽  
Anson Chu ◽  
Matthew Wilson
Keyword(s):  
Systematic Review ◽  
Complication Rate ◽  
Interphalangeal Joint ◽  
Effective Procedure ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Weighted Mean ◽  
Patient Demographics ◽  
Contributory Factors

Category: Midfoot/Forefoot Introduction/Purpose: Hallux interphalangeal joint (HIPJ) arthrodesis is an effective procedure to treat pain and provide stability, which is often performed for intrinsic pain to the HIPJ. Additionally, this procedure is typically employed in concert with the Jones tenosuspension. Despite that this is an accepted technique, the available literature is scant and questions remain regarding nonunion rates and contributory factors to poor healing. A systematic review of the literature was undertaken to determine the rate of nonunion for HIPJ arthrodesis. Methods: To acquire the highest quality and most relevant studies available, publications were eligible for inclusion only if they involved patients undergoing HIPJ arthrodesis. Studies additionally required mean follow-up of at least six weeks and inclusion of appropriate detail regarding complications, nonunion rates, and patient demographics. Ultimately, 7 studies involving 313 HIPJ arthrodeses met inclusion criteria. Results: A total of 291 patients with a weighted mean age of 48.9 were included. The nonunion rate was 28.3% at a weighted mean follow-up of 8.4 months. The overall complication rate was 33.0%. Conclusion: Considering the increased rate of complications and nonunions for this commonly employed procedure, additional prospective comparative analyses are needed to identify important patient demographics and to determine superior fixation constructs.

Is bipolar over diagnosed in adolescents?

2017 ◽  
Vol 41 (S1) ◽  
pp. S451-S451
Author(s):  
S. Paulino ◽  
N. Santos ◽  
A.C. Almeida ◽  
J. Gonçalves
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Statistical Analysis ◽  
Mood Stabilizers ◽  
Review Of The Literature ◽  
Mood Instability ◽  
Adolescent Population ◽  
Life Threatening ◽  
Competing Interest

IntroductionSince the mid-1990s, the diagnosis of bipolar disorder has increased significantly: two-fold among adults, four-fold among adolescents and 40-fold among children. Mood instability is a hallmark symptom of many psychiatric disorders but does not imply necessarily a diagnosis of bipolar disorder. Misdiagnosis is not just an academic issue: mood stabilizers have significant adverse effects and expose patients to side effects that range from mild to potentially life-threatening.ObjectivesDiscuss the potential overestimation of bipolar diagnosis in the adolescent population through a statistical analysis of a sample from the adolescence's consultation of Centro Hospitalar Lisboa Norte.MethodsAnalysis of 106 patients taking into account the initial diagnosis and the diagnostic stability over 6 months. Non-systematic review of the literature.ResultsFrom this sample, 39.2% of the adolescents have a diagnose of unipolar affective disorder, 0.02% of bipolar disorder and 0.1% of disruptive mood disorder. These diagnoses did not change over the follow-up period.ConclusionIt is important to try to understand the reasons of this potential discrepancy (influence of pharmaceutical company marketing, of parents’ desire, of doctors’ fear) to reduce controversy and confusion and to adjust treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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