Patients with migraine more likely to have PTSD

Posttraumatic stress disorder is more common among those with chronic daily headache and episodic migraine than among the general population. Those with PTSD also have greater levels of disability linked to the head pain, according to a study in the April Headache: The Journal of Head and Face Pain. The authors say this finding indicates that a history of trauma or abuse can translate to a range of medical problems that can be costly for the health system.

"These numbers appear to be pretty elevated. We need to take seriously that abuse and traumatic events can really impact your health," said Lee Peterlin, DO, lead author and director of the headache clinic at Drexel University College of Medicine in Philadelphia.

For instance, this paper reported that slightly more than 42% of those with any headache disorder had been subjected to some type of abuse. This circumstance also was true of nearly 65% of those with serious head pain and PTSD.

Why these two problems would occur more commonly together is unknown. Several studies have suggested both disorders may have overlapping root causes in the autonomic system. The authors are advocating detecting and treating PTSD in those with migraine.

"Studies do suggest that treatment of PTSD can result in a significant reduction in pain," said Dr. Peterlin.

The authors surveyed 767 people presenting for care at a half-dozen headache centers, finding that 593 had episodic migraine or chronic daily headache. Previous studies of the general population found a rate of PTSD around 8%, but approximately 25% of the headache group had this mental illness.

Those with both headache and anxiety disorders were more disabled by their pain. Those who had depression as well also were at higher risk for developing a chronic headache disorder.