Influence of psychiatric comorbidities in migraineurs in the emergency department

Gen Hosp Psychiatry. Sep-Oct 2014;36(5):533-8. doi: 10.1016/j.genhosppsych.2014.05.004. Epub 2014 May 17.

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.

Keywords: Emergency department; Healthcare utilization; Migraine; Narcotics; Psychiatric.

MeSH terms

  • Adult
  • Comorbidity
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Health Services / statistics & numerical data*
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Migraine Disorders / epidemiology*
  • Migraine Disorders / therapy
  • Registries / statistics & numerical data*
  • Young Adult