Influence of psychiatric comorbidities in migraineurs in the emergency department

• Published in: General hospital psychiatry Vol. 36; no. 5; pp. 533 - 538
• Main Authors: Minen, Mia T., M.D., M.P.H, Tanev, Kaloyan, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2014; Elsevier
• Subjects: Adult; Biological and medical sciences; Comorbidity; Emergency department; Emergency Service, Hospital - statistics & numerical data; Female; General aspects; Health Services - statistics & numerical data; Health Services - utilization; Healthcare utilization; Humans; Male; Medical sciences; Mental Disorders - epidemiology; Middle Aged; Migraine; Migraine Disorders - epidemiology; Migraine Disorders - therapy; Narcotics; Neurology; Psychiatric; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries - statistics & numerical data; Vascular diseases and vascular malformations of the nervous system; Young Adult; Emergency department; Narcotics; Healthcare utilization; Migraine; Psychiatric; Nervous system diseases; Illicit drug; Cardiovascular disease; Cerebral disorder; Vascular disease; Concomitant disease; Pain; Central nervous system disease; Mental disorder; Cerebrovascular disease; Public health
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2014.05.004

Abstract Objective To examine how psychiatric comorbidities in migraineurs in the emergency department (ED) affect healthcare utilization and treatment tendencies. Method This is a cross-sectional analysis of 2872 patients who visited our ED over a 10-year period and were given a principal diagnosis of migraine. Results Compared to migraineurs without a psychiatric comorbidity, migraineurs with a psychiatric comorbidity had about three times more ED visits, six times more inpatient hospital stays and four times more outpatient visits. Migraineurs with psychiatric comorbidities received narcotics in the ED more often than migraineurs without psychiatric comorbidities ( P <0.0001). In addition, migraineurs with psychiatric disorders were more likely to have a computed tomography scan of the head [Risk Ratio (RR) 1.42 (95% confidence interval (CI)=1.28–1.56, P <0.001)] or a magnetic resonance image of the brain [RR 1.53 (95% CI=1.33–1.76, P <0.001)] than patients without a psychiatric disorder when visiting our hospital center. Conclusions Migraineurs with psychiatric comorbidity who visit the ED have different healthcare utilization tendencies than migraineurs without psychiatric comorbidity who visit the ED. This is seen in the frequency of ED visits, outpatient visits and inpatient stays, in the medications administered to them and in the radiology tests they undergo.