Migraine, GI symptoms increase risk of adverse psychiatric comorbidities

Key takeaways:

• Diagnosis of migraine, gastrointestinal issues intersect and have negative effect on physical health.
• Cognitive behavioral therapy is effective at lessening comorbid psychiatric symptoms.

DENVER — For those diagnosed with migraine, gastrointestinal issues or both, psychiatric comorbidities increase the risk of worsened physical and mental states, according to an expert at the American Academy of Neurology annual meeting.

“As medical providers, we often find our thinking geared toward a specific field of expertise,” Natalia Murinova, MD, associate professor and director of the University of Washington Medicine Headache Center, said during her presentation. “This approach, while efficient, overlooks the complex interplay of comorbid conditions.”

As physical, mental and digestive health have been shown to be connected through the gut-brain axis, Murinova and colleagues sought to determine prevalence and comorbidities found when gastrointestinal (GI) disorders and migraine intersect.

They conducted a retrospective chart study culled date from the UW Leaf research database from January 2015 to January 2023 to locate more than 236,000 individuals with migraine disorders with and without aura (n = 69,344; 75.5% female), GI disorders (n = 153,717; 58.2% female) or both (n = 13,744; 79.8% female), according to ICD-10-CM code diagnosis who presented to the University of Washington Medical Center, Seattle.

Data analysis showed that approximately 20% of those initially diagnosed with migraine had co-diagnosis of GI issues, while roughly 9% of those dealing with GI issues had comorbid migraine. Additionally, the researchers found that individuals with more than one medical diagnosis of either migraine or GI issues predicted an increased risk of comorbid anxiety and insomnia, as anxiety diagnosis was shown to increase from 15.1% to 51.4% in patients diagnosed with ulcerative colitis with comorbid migraine.

Murinova and colleagues also reported that cognitive behavioral therapy was beneficial to reducing psychological symptoms of disease, particularly in those diagnosed with irritable bowel syndrome.

Research further determined that physicians should screen patients for anxiety and depression if a GI disorder was previously diagnoses, so that medications do not adversely affect calcitonin gene-related peptide activity in the brain.

“We think that comorbid anxiety and depression may increase the GI side effects in patients who have GI disorders,” Murinova said. “We’re also planning to do something called ‘empowered relief,’ a one-time intervention for cognitive behavioral therapy.”