Risks and familial coaggregation of suicide, accident mortality, and psychiatric disorders in first-degree relatives of individuals with migraine

Abstract

Studies have revealed a comorbidity to be common between patients with migraine and those with psychiatric disorders, such as bipolar disorder (BD) and major depressive disorder (MDD). However, considering the substantial epidemiological differences in the prevalence of migraine between Western and Asian countries, further investigation was required to determine whether findings regarding familial coaggregation of migraine and psychiatric disorders can be generalized to Asian populations. Using the Taiwan National Health Insurance Database, we included 822,773 first-degree relatives (FDRs) of individuals with migraine and 3,291,092 FDRs of individuals without migraine. We investigated the prevalence of nine psychiatric disorders—schizophrenia, BD, MDD, autism, attention deficit hyperactivity disorder (ADHD), alcohol use disorder (AUD), substance use disorder (SUD), generalized anxiety disorder (GAD), and panic disorder (PD)—in addition to suicide and accidental death in these individuals. Poisson regression models with robust error variance revealed that the FDRs of individuals with migraine were at higher risks of suicide (relative risk: 1.11) as well as BD (1.09), MDD (1.16), autism (1.08), ADHD (1.23), AUD (1.20), SUD (1.14), GAD (1.23), and PD (1.26) than were those of individuals without migraine. The concurrent presence of psychiatric disorders, migraine, and suicide within families suggests a shared pathomechanism across these medical conditions. Thus, clinicians should closely monitor the mental health of FDRs of individuals with migraine.

Perspective

First-degree relatives of migraine probands had an increased risk of being diagnosed with psychiatric disorders, including schizophrenia, bipolar disorder, major depressive disorder, anxiety disorders, and alcohol or substance use disorders. They also died by suicide, regardless of the individual migraine and psychiatric comorbidities.