Abstract Details

Title Defining the Border-Zone between Episodic Migraine (EM) and Chronic Migraine (CM): Psychiatric Comorbidities and Chronic Pain in the US Population

Topic Headache

Presentation(s) P03 - (-)

Poster/Presentation
Number 109

Objective

Background BACKGROUND: Although CM is defined by headaches on 15 or more days per month (d/mo) with a link to migraine, the clinical and biological border between EM and CM is uncertain. One important aspect of specifying case definitions is comorbidities.

Design/Methods DESIGN/METHODS: The American Migraine Prevalence and Prevention Study (AMPP) is a longitudinal, US-population-based study. Depression (using the Patient Health Questionnaire [PHQ-9]) and report of lifetime history of having received a diagnosis of "nervousness or anxiety", "bipolar disorder/mania", and "chronic pain" were assessed. Odds ratios (ORs) and 95% Wald confidence intervals (CIs) adjusted for age, gender and income were calculated comparing groups.

Results RESULTS: Of 16,573 respondents with migraine to the 2005 AMPP survey, 10,609 had LFEM, 640 had HFEM and 655 had CM. Contrasting those groups cross-sectionally, the proportion of anxiety increased from LFEM (18.8%) to CM (30.2%) with statistically significant differences between CM compared to LFEM (OR 1.80, 95% CI 1.51, 2.15; p?0.001). The same pattern was true for bipolar disorder (CM vs. LFEM: OR=1.56, 95% CI 1.51, 2.15; p?0.001), and depression (CM vs. LFEM: OR=2.00, 95% CI 1.67, 2.49; p?0.001). However, rates of these psychiatric conditions were not significantly different between HFEM and CM. Rates of chronic pain also increased across headache frequency groups (LFEM=15.1%, HFEM=23.4%, CM=31.5%) and were significantly different among all three groups.

Conclusions CONCLUSIONS: Those with CM have higher rates of psychiatric commodities and chronic pain than persons with LFEM; however, CM and HFEM only differ in odds of chronic pain and not on the psychiatric comorbidities assessed.

Authors/Disclosures
Dawn C. Buse, PhD (Dawn C. Buse, PhD) PRESENTER	Dr. Buse has received personal compensation for serving as an employee of Vector Psychometric Group. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranicsa. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Buse has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. The institution of Dr. Buse has received research support from Amgen. The institution of Dr. Buse has received research support from FDA. The institution of Dr. Buse has received research support from National Headache Foundation.
	No disclosure on file
Stephen Wanaski, PhD (Paragon Biosciences)	Dr. Wanaski has received personal compensation for serving as an employee of Paragon Biosciences. Dr. Wanaski has or had stock in Paragon Biosciences.Dr. Wanaski has or had stock in Emalex Biosciences.
Michael L. Reed, PhD (Vedanta Research)	The institution of Dr. Reed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. The institution of Dr. Reed has received research support from Allergan. The institution of Dr. Reed has received research support from Dr Reddy's Labs/Promius. The institution of Dr. Reed has received research support from Allay Lamp. Dr. Reed has a non-compensated relationship as a Research Analyst with National Headache Foundation that is relevant to AAN interests or activities.
Jelena M. Pavlovic, MD, PhD (Albert Einstein College of Medicine)	Dr. Pavlovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven.
	No disclosure on file
Shirin Issa, MD	No disclosure on file
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.

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