Migraine Headache in Affectively Ill Latino Adults of Mexican American Origin Is Associated With Bipolarity

Avast array of idiopathic somatic complaints, including but not limited to pain, are common among depressed persons across the lifespan.1–7 Pain as a component of depressive syndromes occurs across cultures.8,9 The results of 2 key studies suggest that about 90% of depressed patients experience pain.10,11 Pain stemming from depression exacts a great toll in terms of human suffering, psychosocial impairment, and economic costs. A study of the financial burden posed by pain in a large urban primary care practice compared the direct costs of treating patients with (n = 207) and without (n = 821) major depressive disorder (MDD) over a 12-month period.12 The cost of caring for patients with MDD ($19,838) was over 3-fold greater than that of nondepressed patients ($6,268). This elevated cost was completely due to an increased demand for services by depressed persons with moderate or greater pain.12 Headache, including migraine, is a very common form of moderate to severe, debilitating pain experienced by depressed persons, as evident from the review of literature included here. Study of various types of pain, including migraine existing in the context of affective disorders, is accordingly an important topic for investigation. The first objective of this study was to measure the prevalence of migraine headache among depressed Latino adults of Mexican American origin with bipolar disorder (BPD) and MDD. The second aim was to explore the possibility that the prevalence of migraine headache differs as a function of polarity. The third aim was to contrast the prevalence of migraine headache among patients with affective illness to nonaffectively ill psychiatric comparison patients. Many investigators have studied the relationship between migraine headache and affective disorders,13–25 and previous authors have reported a high prevalence of migraine among both patients with BPD and MDD but have not found differences in prevalence as a function of polarity.13,15,16