Exploring the relationship between migraine and mental health - perspectives from the patient and physician experience.

Objective: There is growing interest in the impact of multimorbidity in migraine, especially between migraine and mental health conditions. The relationship between migraine and mental health is bi-directional, people with migraine are more likely to experience anxiety and depression and people with anxiety and depression are more likely to experience migraine. Despite advancements in migraine treatment, there is limited awareness and access to mental health treatment for patients with migraine. This study aimed to examine the relationship between migraine and mental health and explore the perspectives of patients living with migraine and physicians treating migraine. Methods: A cross-sectional, observational, online survey conducted between April and May 2022 to describe the experience and perspectives of patients living with migraine, and the physicians treating migraine. Results: 1,100 people (84.7% female; mean age, 46.4 years) with self-reported migraine and 302 physicians who treat migraine completed the survey. Nearly half of patients with migraine (48.8%) reported their mental health as" poor" or "fair," with 78.9% endorsing an anxiety disorder and 63.6% depression. Most patients (84.1%) and physicians (88.7%) agreed that as migraine attacks worsen or become more frequent, mental health burden increases. People with migraine reported feelings of frustration (45.1%), stress (37.0%), and anxiety (34.2%), whereas physicians reported those feelings in 70.9%, 56.3%, and 37.4% of their patients, respectively. Only 28.1% of people with migraine stated their physician frequently asked about their mental health, whereas 70.5% of physicians stated they often do so. Half (49.0%) of patients were not satisfied with the mental health guidance they receive from the physician treating their migraine. Most of both groups (patients, 87.0%; physicians, 93.7%) agreed that improved migraine control would benefit patients' mental health. Conclusion: This study emphasized the importance of optimizing the management of migraine and mental health needs of patients concurrently. Physicians who treat migraine should be sensitive to mental health comorbidities, and internal and external stigmas experienced by patients. There is a need for providing physicians who treat migraine with additional educational initiatives and resources geared toward understanding patient needs, as well as having comprehensive care plans and resources available to provide support to patients.