To evaluate the likelihood and cost-burden of mental health (MH) comorbidities and emergencies associated with migraine.

Migraine can be comorbid with several psychiatric disorders including depression, anxiety disorders, and suicide attempts. Friedman, et. al found that patients with migraines had a 2.07-fold increased odds of suicidal behaviors compared to others. Currently, the likelihood of a migraine patient admitted with diagnoses of MH disease and the cost-burden of MH admissions associated with a migraine patient has not been studied.

Weighted analysis were performed using Nationwide Inpatient Sample from 2008 to 2010. MH comorbidities were determined through the NIS Clinical Classification Software (CCS), including adjustment, anxiety, cognitive, developmental, pediatric, attention deficit, impulse control, mood, personality, schizophrenia, alcohol use, substance use, suicide attempt, MH screening and miscellaneous disorders. Survey logistic regression model was adopted to analyze the odds ratio (OR) of admissions with MH disorders and OR of primary MH disorder admissions for patients with migraines. Excess inpatient length of stay (LOS) and cost of care for MH disorder admission indirectly related to migraine were estimated.

Inpatients with vs. without migraine had higher odds of MH disorders overall (47.2% vs. 25.7%; adjusted OR [95% confidence interval] 2.82 [2.75–2.89]) and in all 15 individual MH disorders examined except cognitive and developmental disorders). Inpatients with vs. without migraine were more likely to be admitted with a primary diagnosis of a MH disorder (10.3% vs. 5.4%; 2.13 [1.98–2.29]), particularly adjustment, anxiety, mood, and personality disorders. Annually, migraines were indirectly related to an excess of 90,815 LOS days, and an excess of $183.68 million cost of care for MH disorders hospitalizations.

Patients with migraine had increased likelihood of comorbid MH disorders and emergencies requiring hospitalization. Optimized approaches are needed for screening and managing MH comorbidities of this vulnerable population.