Migraines Can Signal Psychiatric Woes in Returning Iraq Vets

Headache sufferers twice as prone to PTSD or depression, study finds
THURSDAY, May 3 (HealthDay News) — Almost one in every five U.S. soldiers returning from Iraq is being diagnosed with migraines, and this group has nearly double the risk for depression, post-traumatic stress disorder and other psychiatric troubles, a new study finds.

“Any health-care provider who is evaluating a combat veteran for headaches should perform a mental health screen to ensure that comorbid psychiatric conditions are being identified and treated,” said study author Maj. Jay C. Erickson, M.D., a neurologist at Madigan Army Medical Center at Fort Lewis, in Tacoma, Wash.

Erickson’s team is scheduled to present its findings Thursday at the American Academy of Neurology annual meeting, in Boston.

Links between anxiety, depression and migraine are not new, experts said.

“In fact, I published an article way back in 1967 on headaches and depression,” said Dr. Seymour Diamond, a migraine specialist who is executive chairman of the National Headache Foundation. “Migraine definitely can be linked to psychiatric morbidity.”

However, Erickson’s study is unique. Not only is it the first such study conducted in a military population, “it is also the first study to look at the link between migraine and post-traumatic stress disorder (PTSD),” Erickson said.

In the study, Erickson’s team analyzed questionnaires filled out by almost 2,200 U.S. Army soldiers within 90 days of their return from a year of combat duty in Iraq. Most of the veterans “did have significant exposure to combat situations” while serving in Iraq, Erickson noted.

According to the researchers, 19 percent of the veterans were found to suffer from migraine headaches, 32 percent tested positive for depression, 22 percent met the standard for PTSD, and 13 percent tested positive for anxiety.

Half of the soldiers who suffered from migraines were also clinically depressed, compared to just 27 percent of those without the painful headaches, the researchers reported. And 39 percent of migraine sufferers were also deemed to have PTSD, compared to just 18 percent of soldiers without migraines. Anxiety disorders were also higher among migraine-prone veterans (22 percent) compared to those without the headaches (10 percent).

The numbers for depression “are in the same range as has been seen in the general population,” Erickson said. Comparisons are tougher when it comes to the PTSD-migraine link, he said, “because I don’t think that that has ever been examined in a non-military population.”

It’s also difficult to assess whether the pain of migraine helps trigger depression and anxiety in returning soldiers, or whether these types of psychological ills help spur migraines.

“The study design did not allow us to determine the sequence of events,” Erickson explained. However, he noted that “some studies that have been done in the general population suggest that it may be a bi-directional relationship.”

Diamond agreed. “For example, if migraines are not controlled properly, they would most likely bring on depression,” he said. On the other hand, anxiety “is a frequent trigger for migraine,” he said.

Whatever their cause, most migraines can be curbed or controlled, according to Diamond. “However, the National Headache Foundation did a study and found that there are so many sufferers who haven’t had proper treatment,” he said. “This is a reminder that there are medicines out there both to prevent and treat the acute attack.”

Erickson believes the new findings should serve as a wake-up call to military and civilian doctors to look a bit further whenever they spot migraines in a patient, because those headaches could point to psychological troubles, as well.

“That’s the main recommendation here,” he said.

Source: National Institute of Health

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