Revisiting the bipolar disorder with migraine phenotype: Clinical features and comorbidity

Francisco Romo-Nava, Thomas Blom, Alfredo B. Cuellar-Barboza, Oluwole O. Awosika, Brian E. Martens, Nicole N. Mori, Colin L. Colby, Miguel L. Prieto, Marin Veldic, Balwinder Singh, Manuel Gardea-Resendez, Nicolas A. Nunez, Aysegul Ozerdem, Joanna M. Biernacka, Mark A. Frye, Susan L. McElroy

Research output: Contribution to journalArticlepeer-review


Introduction: To evaluate the prevalence and clinical correlates of lifetime migraine among patients with bipolar disorder (BD). Methods: In a cross-sectional study, we evaluated 721 adults with BD from the Mayo Clinic Bipolar Disorder Biobank and compared clinical correlates of those with and without a lifetime history of migraine. A structured clinical interview (DSM-IV) and a clinician-assessed questionnaire were utilized to establish a BD diagnosis, lifetime history of migraine, and clinical correlates. Results: Two hundred and seven (29%) BD patients had a lifetime history of migraine. BD patients with migraine were younger and more likely to be female as compared to those without migraine (p values <0.01). In a multivariate logistic regression model, younger age (OR=0.98, p<0.01), female sex (OR=2.02, p<0.01), higher shape/weight concern (OR=1.04, p=0.02), greater anxiety disorder comorbidities (OR=1.24, p<0.01), and evening chronotype (OR=1.65, p=0.03) were associated with migraine. In separate regression models for each general medical comorbidity (controlled for age, sex, and site), migraines were significantly associated with fibromyalgia (OR=3.17, p<0.01), psoriasis (OR=2.65, p=0.03), and asthma (OR=2.0, p<0.01). Participants with migraine were receiving ADHD medication (OR=1.53, p=0.05) or compounds associated with weight loss (OR=1.53, p=0.02) at higher rates compared to those without migraine. Limitations: Study design precludes determination of causality. Migraine subtypes and features were not assessed. Conclusions: Migraine prevalence is high in BD and is associated with a more severe clinical burden that includes increased comorbidity with pain and inflammatory conditions. Further study of the BD-migraine phenotype may provide insight into common underlying neurobiological mechanisms.

Original languageEnglish (US)
Pages (from-to)156-162
Number of pages7
JournalJournal of Affective Disorders
StatePublished - Dec 1 2021

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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