Psychiatric and medical comorbidities in patients with migraine before and during the COVID-19 pandemic in Thailand: a retrospective comparative cohort study of two different clinical groups.

Publication date: Jul 17, 2026

Psychiatric and medical comorbidities are common in migraine and worsen pain burden and treatment outcomes. We examined the prevalence of comorbidities overall, before and during the COVID-19 pandemic, across migraine subtypes, and identified associated risk factors. This retrospective comparative cohort study included patients diagnosed with migraine according to the International Classification of Headache Disorders at a tertiary headache center in Thailand. Clinical data were obtained from standardized case record forms and electronic medical records. Comorbidities were self-reported at the initial visit and verified by documented diagnoses. Group differences were analyzed using chi-square or independent t-tests. Multivariable logistic regression identified independent risk factors. Of the 572 patients, 29. 9% had migraine with aura. Overall, 67. 7% had at least one comorbidity, and 8. 0% had psychiatric comorbidities. During the COVID-19 pandemic, overall and psychiatric comorbidities were more prevalent than in the pre-2020 period (79. 4% vs. 66. 2% and 17. 4% vs. 6. 9%, respectively). Chronic migraine was independently associated with comorbidities (adjusted OR 1. 67, 95% CI 1. 11-2. 51), whereas the pre-COVID-19 period was associated with lower odds. Comorbidities are highly prevalent in migraine, particularly during the COVID-19 pandemic and among patients with chronic migraine. Integrated pain management and routine psychiatric screening may improve comprehensive care.

Semantics

Original Article