Morbidades psiquiátricas na migrânea com e sem abuso de medicaçõesanalgésicas

Abstract

Ten to 15 per cent of the general population suffer from migraine and a certain percentage of these individuals will develop medication overuse. Psychiatric comorbidity has been consistent observed in migraineurs and generally increase the impact of headache and decrease quality of life, leading to worst therapeutic response, poor prognosis and increasing medical costs. The objectives of the present study are to verify the prevalence of psychiatric disorders in patients seen at the Headaches Center of Department of Neurology at Federal University of Minas Gerais, Belo Horizonte, Brazil and to evaluate the impact of these disorders in quality of life of this population and to assess possible clinical andsocio-demographic associated variables. We also compared patients with migraine with or without analgesic medication overuse.A cross-sectional study was performed including structured psychiatricinterview in 70 individuals with migraine according to International Headache Society (mean age (± SD) 35.5 years-old (±11.50); H/M: 4/64). Mini-Plus was used for psychiatric diagnoses axis I, and BDI, HAD, HAM-D, HAM-A MADRS were the psychopathologic tools used, while HIT, MIDAS, SF-36 were used to evaluate the impact and quality of life. These individuals were divided into two groups: 32 migraineurs plus analgesic overuse (45.7%) and 38 migraineurs without analgesic overuse (54.3%). Psychiatric disorders were diagnostic in 57 patients (81.4%); 87.5%those with analgesics overuse group and 76.3 % without analgesic overuse group (p=0.23). Only somatization disorder was more prevalent in migraine plus analgesic overuse group (n=6; 18.8%) than in migraineurs without analgesic overuse (n=1; 2.6%) (p< 0.05). No statistical differences between groups assessed by scale scores, except for MIDAS, with higher scores in migraine plus analgesic overuse group than those migraineurs without analgesic overuse (p<0.05), indicating highest headaches impact in that group. This study emphasizes that high frequency of psychiatric disorders in patients with migraine and the analgesic overuse shouldnt have increased this prevalence. Nevertheless, migraineurs with analgesic overuse got a higher impact of headache, assessed by MIDAS.