The findings, which appear in the journal Neurology, are based on psychiatric interviews with 121 teenagers who suffered from various forms of chronic headache -- including chronic migraine, chronic tension headache and chronic headaches stemming from pain medication overuse.

Migraine headaches cause intense, throbbing pain, along with sensitivity to light and sound, and nausea in many cases. A minority of migraine sufferers also experience an aura -- visual disturbances or other bodily sensations that precede the migraine attack.

Chronic migraine is diagnosed when the attacks happen at least 15 days out of every month.

In their study, Wang's team found that nearly half of all the 12- to 14-year-old headache sufferers they interviewed had at least one psychiatric disorder. That rate is far higher than what's seen among Taiwanese teenagers in general, they note.

Teens with chronic migraine were particularly at risk, showing higher rates of depression and anxiety disorders -- including panic attacks and obsessive compulsive disorder -- than their peers with other forms of chronic headache.

Suicidal thoughts and behaviors were also unusually common in the study group as a whole, with 20 percent showing a high risk of suicide. But teenagers who suffered migraine with aura were especially at risk.

Of these 14 teens, half showed a high risk of suicide based on a standard questionnaire, versus 21 percent of their peers who suffered migraines without aura, and 7.5 percent of those without migraine.

There's no immediate explanation for why migraine with aura, specifically, would be linked to suicide risk, Wang said. But it's possible that dysfunction in the brain's serotonin system helps explain the link between psychiatric problems and chronic migraine in general, according to the researchers.

Serotonin is a chemical that helps nerve cells communicate, and research has implicated it in both migraine and certain psychiatric disorders, including depression and anxiety.

According to Wang, parents of children with chronic migraine should ask for a consultation with a psychiatrist if they feel their child is depressed or has other mental health problems.

But the researcher also stressed that the findings apply to chronic migraine, and it's unknown whether children with occasional migraine attacks have similarly elevated risks.

SOURCE: Neurology, May 1, 2007.

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