Migraine is a highly prevalent and disabling neurological disorder associated with a wide range of psychiatric comorbidities. In this manuscript, we provide an overview of the link between migraine and several comorbid psychiatric disorders, including depression, anxiety and post-traumatic stress disorder. We present data on psychiatric risk factors for migraine chronification. We discuss the evidence, theories and methods, such as brain functional imaging, to explain the pathophysiological links between migraine and psychiatric disorders. Finally, we provide an overview of the treatment considerations for treating migraine with psychiatric comorbidities. In conclusion, a review of the literature demonstrates the wide variety of psychiatric comorbidities with migraine. However, more research is needed to elucidate the neurocircuitry underlying the association between migraine and the comorbid psychiatric conditions and to determine the most effective treatment for migraine with psychiatric comorbidity.

BackgroundThere is a current and pressing need for recovery resources for individuals suffering from eating disorders. Mentoring programs have been useful with other psychiatric disorders such as addictions, and may be useful for individuals recovering from an eating disorder. The present study sought to examine a mentoring program for individuals working towards recovery from an eating disorder.MethodsThe study included mentors (i.e., individuals who have recovered from an eating disorder for an extended period of time), and mentees (i.e., individuals who were in the process of recovering from an eating disorder and wanting additional support aside from their treatment team). Participants included 141 participants, consisting of 34 mentors, 58 mentees who matched with a mentor, and 49 mentees searching for a mentor. Participants completed questions assessing eating disorder symptoms, quality of life, motivation towards recovery, and treatment compliance.ResultsMatched mentees reported higher levels of quality of life on 7 out of 12 domains, and missed fewer appointments with treatment providers when compared to unmatched mentees. There were no differences between matched and unmatched mentees on motivation, energy or confidence towards recovery.ConclusionsFindings suggest a mentor model is beneficial for individuals engaged in the process of recovering from an eating disorder in the areas of quality of life and treatment compliance. Specifically, mentees in a mentoring relationship reported better family and close relationships, future outlook, and psychological, emotional, and physical well-being than unmatched mentees. Mentors reported being positively impacted by the mentoring relationship by strengthening the skills they learned while in recovery, and reminding them of how far they had come in their own recovery. The findings in this study suggest that mentor programs warrant further investigation as ancillary support services for individuals recovering from an eating disorder.

Objectives: We have had success treating children with severe rumination syndrome using a multidisciplinary intensive outpatient program (IOP) involving multiple treatment sessions daily. During the coronavirus disease 2019 (COVID-19) pandemic, we temporarily transitioned care to telemedicine. The objective of this study is to compare outcomes of patients with rumination syndrome who completed IOP treatment in person versus by telemedicine. Methods: We performed a retrospective review of patients diagnosed with rumination syndrome who participated in IOP treatment from 2018 to 2020. Similar treatment sessions were performed involving medical and behavioral techniques provided by a multidisciplinary team during telemedicine visits. Families/patients were asked to complete a survey outlining their child’s current rumination symptom severity and review the IOP. Results: We included 34 patients (79% F, median age 15 years, range 7–19 years) who completed IOP treatment. Twenty-six patients (76%) were treated in person and 8 patients (24%) by telemedicine. For patients treated in person, 76% (19/25) had improvement in symptoms while 16% (4/25) had complete resolution of symptoms. For patients treated by telemedicine, 88% (7/8) had improvement in their symptoms. There were no significant differences between groups in likelihood of improvement. Overall, 78% (18/23) preferred in person therapy while 17% (4/23) did not have a preference. All 18 of the in-person cohort who completed follow-up surveys preferred in-person management. Conclusions: Multidisciplinary intensive outpatient treatment for children and adolescents with severe rumination syndrome is effective. Although telemedicine may be an alternative to in person therapy, majority of families prefer in person visits.

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