Physical–Mental Comorbidity of Pediatric Migraine in the Philadelphia Neurodevelopmental Cohort - 30/10/18

Doi : 10.1016/j.jpeds.2018.09.033

Tarannum Lateef, MD, MPH ^1,^2,³, Jian-Ping He, MSc ³, Karin Nelson, MD ³, Monica E. Calkins, PhD ⁴, Ruben Gur, PhD ⁴, Raquel Gur, MD, PhD ⁴, Kathleen R. Merikangas, PhD ^3,^*
¹ Department of Neurology, The Center for Neuroscience and Behavioral Medicine, Children's National Medical Center, Washington, DC
² Pediatric Specialists of Virginia, Woodbridge, VA
³ Genetic Epidemiology Branch, National Institute of Mental Health, Bethesda, MD
⁴ Neuropsychiatry Section and Brain Behavior Laboratory and Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

^*Reprint requests: Kathleen R. Merikangas, PhD, Genetic Epidemiology Branch, Intramural Research Program National Institute of Mental Health, 35 Convent Dr, MSC#3720, Bethesda, MD 20892.Genetic Epidemiology BranchIntramural Research Program National Institute of Mental Health35 Convent DrMSC#3720BethesdaMD20892

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 30 October 2018
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Objective

To examine the associations between headaches and migraine with physical and mental disorders in a large pediatric registry.

Study design

In total, 9329 youth aged 8-21 years from the Philadelphia Neurodevelopmental Cohort were included. Physical conditions, including headache, were ascertained from electronic medical records and in-person interviews. Modified International Classification of Headache Disorders (ICHD-II) criteria were used to classify migraine symptoms. Forty-two other physical conditions were classified into 14 classes of medical disorders. Mental disorders were assessed using an abbreviated version of the Kiddie-Schedule for Affective Disorders and Schizophrenia.

Results

Lifetime prevalence of any headache was 45.5%, and of migraine was 22.6%. Any headache was associated with a broad range of physical disorders, attention-deficit/hyperactivity disorder (OR 1.2 [95% CI 1.1-1.4]), and behavior disorders (1.3 [1.1-1.5]). Youth with migraine had greater odds of specific physical conditions and mental disorders, including respiratory, neurologic/central nervous system, developmental, anxiety, behavior, and mood disorders than those with nonmigraine headache (OR ranged from 1.3 to 1.9).

Conclusions

Comorbidity between headaches with a range of physical conditions that have been associated with adult migraine demonstrates that multimorbidity occurs early in development. Comorbidity may be an important index of heterogeneity of migraine that can guide clinical management, genetic investigation, and future research on shared pathophysiology with other disorders.

Le texte complet de cet article est disponible en PDF.

Keywords : migraine, headache, mental disorder, physical condition, comorbidity, Philadelphia Neurodevelopmental Cohort

Abbreviations : ADHD, CGAS, CHOP, EMR, ICHD-II, PNC

Plan

Methods

Physical Conditions Classifications

Headache Subtype Ascertainment

Mental Disorder Assessment

Statistical Analyses

Results

Discussion

Supported by National Institute of Mental Health (5RC2MH089983 [to R.G.] and ZIAMH002931) and the Intramural Research Program of the National Institute of Mental Health project (to T.L., K.N., K.M., J-P.H.) The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or US Government. The authors declare no conflicts of interest.