Suicide in primary headaches in 48 countries: A physician-survey based study

Trejo-Gabriel-Galán, J.M.; Aícua‐Rapún, Irene; Cubo-Delgado, Esther; Velasco-Bernal, Carmen

doi:10.1177/0333102417714477

Cited by 20 publications

(11 citation statements)

References 9 publications

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“…It is well known that CM is associated to psychiatric comorbidities, including anxiety and depression (32,33), which may play a signi cant role in the way one perceives pain, copes with it and maintains a normal lifestyle. Furthermore, evidence from other elds of research showed that adults with anxiety disorders reportedly experienced signi cantly more total life events, perceived them as being more stressful, and adapted to them less well than normal controls (34,35).…”

Section: Discussionmentioning

confidence: 99%

Psychological Predictors of Negative Treatment Outcome with Erenumab in Chronic Migraine: Data From an Open Label Long-Term Prospective Study

Bottiroli

Icco

Vaghi

et al. 2021

Preprint

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BackgroundMonoclonal antibodies (mABs) targeting the calcitonin gene-related peptide (CGRP) pathway represent the first disease-specific preventive migraine therapy. A wealth of evidence has shown that they are effective in the preventive treatment of difficult-to-treat patients. In this study, we evaluated the psychological predictors of the outcome of treatment with the anti-CGRP monoclonal antibody erenumab in patients with chronic migraine (CM).MethodsSeventy-five patients with CM who had already failed at least 3 preventive therapies received erenumab every 28 days for a period of 12 months. Before the first administration, patients received a full psychological evaluation using The Structured Clinical Interview for DSM-5 Clinician Version (SCID-5-CV) to assess personality disturbances (primary outcome), mood and anxiety disorders, and as well specific questionnaires to evaluate alexithymia traits, childhood traumas, and current stressors (secondary outcomes).ResultsAfter 12 months of treatment, 53 patients reported a reduction of at least 50% in headache days/per month (Responders-R), whereas 22 did not (Non Responders-NR). When compared to R, NR were characterized by a higher prevalence of personality disorders belonging to Cluster C (avoidant, dependent, and obsessive-compulsive) (77% vs 37%, p = .001). NR were also characterized by a higher prevalence of anxiety disorders (90% vs 60%, p = 0.007), showed more alexithymic traits (51.7 ± 13.7 vs 42.9 ± 14.3, p = 0.017), and reported a higher number of at least serious current stressors (3.2 ± 4.0 vs 0.8 ± 1.4, p < .0001) than R. At the multivariate analysis, higher prevalence of Cluster C personality disorders (OR 3.697; p = 0.05) and higher number of at least serious life events (OR 1.382; p = 0.017) arose as prognostic factors of erenumab failure.ConclusionsErenumab confirmed its effectiveness in a population of difficult-to-treat migraine. The presence of “anxious-fearful” personality together with current stressors and anxiety represent negative predictors of treatment outcome.Trial registrationThe study protocol was registered at clinicaltrials.gov (NCT04361721).

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Section: Discussionmentioning

confidence: 99%

Psychological Predictors of Negative Treatment Outcome with Erenumab in Chronic Migraine: Data From an Open Label Long-Term Prospective Study

Bottiroli

Icco

Vaghi

et al. 2021

Preprint

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“…Both migraine and psychiatric disorders are prevalent and burdensome conditions challenging the health care systems worldwide [1–5]. These conditions show a large overlap [6, 7] and epidemiological studies suggest that patients with migraine – especially those with chronic migraine (CM) and migraine with aura – are at increased risk for major depression, anxiety, or suicidal behavior when compared to subjects without migraine (e.g., [8–10]). Besides, according to a recent large genome-wide association study, when compared to other neurological disorders, migraine showed a higher genetic correlation with psychiatric disorders suggesting common genetic bases or pathways [11].…”

Section: Introductionmentioning

confidence: 99%

Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications

Dresler¹,

Caratozzolo

Guldolf³

et al. 2019

J Headache Pain

159

152

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BackgroundMigraine is a highly prevalent and disabling neurological disorder which is commonly linked with a broad range of psychiatric comorbidities, especially among subjects with migraine with aura or chronic migraine. Defining the exact nature of the association between migraine and psychiatric disorders and bringing out the pathophysiological mechanisms underlying the comorbidity with psychiatric conditions are relevant issues in the clinical practice.MethodsA systematic review of the most relevant studies about migraine and psychiatric comorbidity was performed using “PubMed”, “Scopus”, and “ScienceDirect” electronic databases from 1 January 1998 to 15 July 2018. Overall, 178 studies met our inclusion criteria and were included in the current review.ResultsAccording to the most relevant findings of our overview, the associations with psychiatric comorbidities are complex, with a bidirectional association of major depression and panic disorder with migraine. Importantly, optimizing the pharmacological and non-pharmacological treatment of either migraine or its psychiatric comorbidities might help clinicians to attenuate the burden of both these conditions.ConclusionsThe available data highlight the need for a comprehensive evaluation of psychiatric disorders in migraine in order to promote an integrated model of care and carefully address the burden and psychosocial impairment related to psychiatric comorbidities in migraine.

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“…Cluster headache (CH) is a headache disorder widely regarded as one of the most painful human experiences (Burish et al 2020) with a high rate of suicidal thoughts and attempts (Ji Lee et al 2019;Rozen and Fishman 2012;Trejo-Gabriel-Galan et al 2018). The diagnosis of cluster headache is made by defining criteria: 1-8 headache attacks per day of one side of the face, with each attack lasting between 15 min and 3 h, associated with restlessness and/or cranial autonomic features, such as a bloodshot eye and nasal congestion on the same side as the pain (Headache Classification Committee of the International Headache Society (IHS) 2018).…”

Section: Introductionmentioning

confidence: 99%

The first-line cluster headache medication verapamil alters the circadian period and elicits sex-specific sleep changes in mice

Burish

Han

Mawatari

et al. 2021

Chronobiology International

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Verapamil is the first-line preventive medication for cluster headache, an excruciating disorder with strong circadian features. Whereas second-and third-line preventives include known circadian modulators, such as melatonin, corticosteroids, and lithium, the circadian effects of verapamil are poorly understood. Here, we characterize the circadian features of verapamil using both in vitro and in vivo models. In Per2::LucSV reporter fibroblasts, treatment with verapamil (0.03-10 µM) showed a dose-dependent period shortening of the reporter rhythm which reached a nadir at 1 µM, and altered core clock gene expression at 10 µM. Mouse wheel-running activity with verapamil (1 mg/mL added to the drinking water) also resulted in significant period shortening and activity reduction in both male and female free-running wild-type C57BL6/J mice. The temporal patterns of activity reduction, however, differ between the two sexes. Importantly, piezo sleep recording revealed sexual dimorphism in the effects of verapamil on sleep timing and bout duration, with more pronounced adverse effects in female mice. We also found altered circadian clock gene expression in the cerebellum, hypothalamus, and trigeminal ganglion of verapamil-treated mice. Verapamil did not affect reporter rhythms in ex vivo suprachiasmatic nucleus (SCN) slices from Per2:Luc reporter mice, perhaps due to the exceptionally tight coupling in the SCN. Thus, verapamil affects both peripheral (trigeminal ganglion) and central (hypothalamus and cerebellum) nervous system structures involved in cluster headache pathophysiology, possibly with network effects instead of isolated SCN effects. These studies suggest that verapamil is a circadian modulator in laboratory models at both molecular and behavioral levels, and sex is an important biological variable for cluster headache medications. These observations highlight the circadian system as a potential convergent target for cluster headache medications with different primary mechanisms of action.

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Suicide in primary headaches in 48 countries: A physician-survey based study

Cited by 20 publications

References 9 publications

Psychological Predictors of Negative Treatment Outcome with Erenumab in Chronic Migraine: Data From an Open Label Long-Term Prospective Study

Psychological Predictors of Negative Treatment Outcome with Erenumab in Chronic Migraine: Data From an Open Label Long-Term Prospective Study

Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications

The first-line cluster headache medication verapamil alters the circadian period and elicits sex-specific sleep changes in mice

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