Migraine, Major Depression and Personality Disorders: Could Obsessive-Compulsive Personality Disorder Mediate the Relationship between Migraine and Depression

Abstract

• Background

Migraine is one of the most common neurological disorders. Major depression is three times more common in migraine patients than in the general population, especially among those with aura. Other personality disorders, such as obsessive-compulsive personality disorder (OCPD) and borderline personality disorder (BPD), are also suggested to be prevalent in patients with migraine. This study aims to investigate personality disorders in migraine patients and their relationship with depression.

• Methods

The study included 83 patients with migraine and 63 participants without migraine, any other type of headache syndrome or neurological disorders in a control group.Demographic and clinical variables were recorded. Neurological and psychiatric examinations were conducted using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Structured Clinical Interview for Axis II Disorders Form, and the MIDAS (The Migraine Disability Assessment Test) score was applied.

• Results

Duration of major depression was significantly longer in migraine patients than healthy controls (p<0.001). Major depression was more frequent in patients with migraine aura (p<0.05).When migraine patients with and without major depression were compared, the MIDAS score was significantly higher in patients with major depression (p<0.05). BPD was neither associated with the presence/absence of migraine nor the pain and attack characteristics. Family history of migraine, OCPD and histrionic and narcissistic PD were at a significantly higher frequency in patients with migraine and major depression comorbidity.

• Conclusion

It seems reasonable to assume that migraine, major depression and personality disorders (most importantly OCPD) are in a close relationship, with the possibility that OCPD is a mediator between the two conditions.