Headache centers have to deal with patients suffering from headache induced
by chronic substance use which is a well-recognized complication of migrai
ne treatment. The objective of this study was to compare psychiatric comorb
idity between migraineurs with and without chronic substance use: 34 migrai
nous inpatients with chronic substance use were compared with 34 sex-matche
d noncomplicated migraineurs in a case-control study. The results showed a
significantly higher prevalence of major depressive disorder, panic disorde
r, and social phobia in the patients with a history of chronic substance us
e. Consistently, anxious and depressive dimensions were significantly highe
r in these patients. Therefore, psychiatric morbidity may be linked to chro
nic substance use in migraineurs. This stresses the importance of psychiatr
ic assessment and the need for appropriate treatment in such patients.