Comorbidity of migraine with ADHD in adults

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Abstract

Background

Migraine and Attention Deficit and Hyperactivity Disorder (ADHD) have been found to be associated in child and adolescent cohorts; however, the association has not been assessed in adults or otherwise healthy population. Assessing the comorbidity between ADHD and migraine may clarify the etiopathology of both diseases. Thus, the objective is to assess whether migraine (with and without visual disturbances) and ADHD are comorbid disorders.

Methods

Participants from the Danish Blood Donor Study ( N = 26,456, age 18–65, 46% female) were assessed for migraine and ADHD using the ASRS ver 1.1 clinically validated questionnaire and self-reported migraine in a cross-sectional study. Logistic regression was used to examine the comorbidity between migraine and ADHD, and their associated endophenotypes.

Results

Migraine was strongly associated with ADHD (OR = 1.8, 95% CI = 1.5–2.1), (238/6152 vs 690/19,376). There was a significant interaction between age and gender, with comorbidity increasing with age and female sex. Post-hoc analysis showed that migraine with visual disturbance was generally associated with a marginally higher risk of ADHD and this was independent of ADHD endophenotypes.

Conclusion

Migraine and ADHD were demonstrated to be comorbid disorders; the association with ADHD was most prominent for participants with migraine with visual disturbances. Future studies will elucidate which genetic and environmental factors contribute to migraine-ADHD comorbidity.

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Most cited references 34

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Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members.

Ronald C Kessler, Lenard Adler, Michael Gruber … (2007)

The validity of the six-question World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener was assessed in a sample of subscribers to a large health plan in the US. A convenience subsample of 668 subscribers was administered the ASRS Screener twice to assess test-retest reliability and then a third time in conjunction with a clinical interviewer for DSM-IV adult ADHD. The data were weighted to adjust for discrepancies between the sample and the population on socio-demographics and past medical claims. Internal consistency reliability of the continuous ASRS Screener was in the range 0.63-0.72 and test-retest reliability (Pearson correlations) in the range 0.58-0.77. A four-category version The ASRS Screener had strong concordance with clinician diagnoses, with an area under the receiver operating characteristic curve (AUC) of 0.90. The brevity and ability to discriminate DSM-IV cases from non-cases make the six-question ASRS Screener attractive for use both in community epidemiological surveys and in clinical outreach and case-finding initiatives. Copyright (c) 2007 John Wiley & Sons, Ltd.

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Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms.

Lenard A. Adler, Thomas L Spencer, Stephen V Faraone … (2006)

The goal of this study was to validate the pilot Adult ADHD Self-Report Scale (pilot ASRS) versus standard clinician ratings on the ADHD Rating Scale (ADHD RS). Sixty adult ADHD patients took the self-administered ADHD RS and then raters administered the standard ADHD RS. Internal consistency of symptom scores was assessed by Cronbach's alpha. Agreement of raters was established by intra-class correlation coefficients (ICCs) between scales. Internal consistency was high for both patient and rater-administered versions (Cronbach's alpha 0.88, 0.89, respectively). The ICC between scales for total scores was also high (0.84); ICCs for subset symptom scores were also high (both 0.83). There was acceptable agreement for individual items (% agreement: 43%-72%) and significant kappa coefficients for all items (p < 0.001). The pilot Adult ADHD Self-Report Scale symptom checklist is a reliable and valid scale for evaluating ADHD for adults and shows a high internal consistency and high concurrent validity with the rater-administered ADHD RS.

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Migraine and psychiatric comorbidity: a review of clinical findings

Fabio Antonaci, Giuseppe Nappi, Federica Galli … (2011)

Migraine is an extremely common disorder. The underlying mechanisms of this chronic illness interspersed with acute symptoms appear to be increasingly complex. An important aspect of migraine heterogeneity is comorbidity with other neurological diseases, cardiovascular disorders, and psychiatric illnesses. Depressive disorders are among the leading causes of disability worldwide according to WHO estimation. In this review, we have mainly considered the findings from general population studies and studies on clinical samples, in adults and children, focusing on the association between migraine and psychiatric disorders (axis I of the DSM), carried over after the first classification of IHS (1988). Though not easily comparable due to differences in methodology to reach diagnosis, general population studies generally indicate an increased risk of affective and anxiety disorders in patients with migraine, compared to non-migrainous subjects. There would also be a trend towards an association of migraine with bipolar disorder, but not with substance abuse/dependence. With respect to migraine subtypes, comorbidity mainly involves migraine with aura. Patients suffering from migraine, however, show a decreased risk of developing affective and anxiety disorders compared to patients with daily chronic headache. It would also appear that psychiatric disorders prevail in patients with chronic headache and substance use than in patients with simple migraine. The mechanisms underlying migraine psychiatric comorbidity are presently poorly understood, but this topic remains a priority for future research. Psychiatric comorbidity indeed affects migraine evolution, may lead to chronic substance use, and may change treatment strategies, eventually modifying the outcome of this important disorder.

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Author and article information

Contributors

Thomas Folkmann Hansen: +45 22825659 , Thomas.hansen@regionh.dk

Louise K. Hoeffding: Louise.K.Enggaard.Hoeffding@regionh.dk

Lisette Kogelman: Lisette.kogelman@regionh.dk

Thilde Marie Haspang: thilde.marie.haspang@regionh.dk

Henrik Ullum: Henrik.Ullum@regionh.dk

Erik Sørensen: Erik.Soerensen@regionh.dk

Christian Erikstrup: christian.erikstrup@skejby.rm.dk

Ole Birger Pedersen: olbp@regionsjaelland.dk

Kaspar René Nielsen: k.nielsen@rn.dk

Henrik Hjalgrim: HHJ@ssi.dk

Helene M. Paarup: helene.paarup@rsyd.dk

Thomas Werge:

ORCID: http://orcid.org/0000-0001-6703-7762

thomas.werge@regionh.dk

Kristoffer Burgdorf: kristoffer.soelvsten.burgdorf@regionh.dk

Journal

Journal ID (nlm-ta): BMC Neurol

Journal ID (iso-abbrev): BMC Neurol

Title: BMC Neurology

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2377

Publication date (Electronic): 16 October 2018

Publication date PMC-release: 16 October 2018

Publication date Collection: 2018

Volume: 18

Electronic Location Identifier: 147

Affiliations

[1 ]ISNI 0000 0004 0646 7373, GRID grid.4973.9, Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, , University Hospital of Copenhagen, ; Copenhagen, Denmark

[2 ]ISNI 0000 0001 0674 042X, GRID grid.5254.6, Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, , University of Copenhagen, ; Copenhagen, Denmark

[3 ]ISNI 0000 0004 0646 7373, GRID grid.4973.9, Department of Clinical Immunology, the Blood Bank, Rigshospitalet, , University Hospital of Copenhagen, ; Copenhagen, Denmark

[4 ]ISNI 0000 0004 0512 597X, GRID grid.154185.c, Department of Clinical Immunology, , Aarhus University Hospital, ; Aarhus, Denmark

[5 ]ISNI 0000 0004 0631 4668, GRID grid.416369.f, Department of Clinical Immunology, , Naestved Hospital, ; Naestved, Denmark

[6 ]ISNI 0000 0004 0646 7349, GRID grid.27530.33, Department of Clinical Immunology, , Aalborg University Hospital, ; Aalborg, Denmark

[7 ]ISNI 0000 0004 0417 4147, GRID grid.6203.7, Department of Epidemiology Research, , Statens Serum Institut, ; Copenhagen, Denmark

[8 ]ISNI 0000 0004 0646 7373, GRID grid.4973.9, Department of Hematology, , Copenhagen University Hospital, ; Rigshospitalet, Copenhagen, Denmark

[9 ]ISNI 0000 0004 0512 5013, GRID grid.7143.1, Department of Clinical Immunology, , Odense University Hospital, ; Odense, Denmark

[10 ]ISNI 0000 0004 0646 7373, GRID grid.4973.9, Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, , Copenhagen University Hospital, ; Roskilde, Denmark

[11 ]ISNI 0000 0001 0674 042X, GRID grid.5254.6, Department of Clinical Medicine, , University of Copenhagen, ; Copenhagen, Denmark

[12 ]The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark

[13 ]ISNI 0000 0004 0646 7373, GRID grid.4973.9, Danish Headache Center, Neurological department, , Copenhagen University Hospital, ; Nordre Ringevej 69, DK-2600 Glostrup, Denmark

Author information

Thomas Werge http://orcid.org/0000-0001-6703-7762

Article

Publisher ID: 1149

DOI: 10.1186/s12883-018-1149-6

PMC ID: 6190553

PubMed ID: 30322380

SO-VID: e554e79e-0f1d-4941-8162-9cf3a87b89da

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 20 June 2018

Date accepted : 11 September 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100005275, Region Hovedstaden;

Award ID: R129-A3973

Award Recipient : Thomas Folkmann Hansen

Funded by: Candy foundation

Award ID: CHEAD

Award Recipient : Thomas Folkmann Hansen

Funded by: FundRef http://dx.doi.org/10.13039/501100003554, Lundbeckfonden;

Award ID: R219-2016-1030

Funded by: FundRef http://dx.doi.org/10.13039/100008392, Sundhed og Sygdom, Det Frie Forskningsråd;

Award ID: 1333-00275A

Award ID: 09-069412

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ScienceOpen disciplines: Neurology

Keywords: migraine,attention deficiency and hyperactivity disorder,comorbidity

Data availability:

ScienceOpen disciplines: Neurology

Keywords: migraine, attention deficiency and hyperactivity disorder, comorbidity

Comorbidity of migraine with ADHD in adults

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Abstract

Background

Methods

Results

Conclusion

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Karger: Neurology and Neuroscience

Most cited references 34

Validity of the World Health Organization Adult ADHD Self-Report Scale (ASRS) Screener in a representative sample of health plan members.

Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms.

Migraine and psychiatric comorbidity: a review of clinical findings

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