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Cluster headache and Bipolar disorders: Phenotypical Overlap and Comorbidity.

Published online by Cambridge University Press:  26 August 2025

M. A. Riedinger ,
R. B. Brandt ,
S. E. Knapen ,
E. J. Giltay ,
N. J. van der Wee ,
R. Fronczek  and
M. de Leeuw
M. A. Riedinger*
Affiliation:
Psychiatry, Leiden University Medical Center Outpatient clinic for mental disability and psychiatry, GGZ Rivierduinen
R. B. Brandt
Affiliation:
Neurology, Leiden University Medical Center, Leiden
S. E. Knapen
Affiliation:
Neurology, Leiden University Medical Center, Leiden
E. J. Giltay
Affiliation:
Psychiatry, Leiden University Medical Center Public Health and Primary Care, Leiden University Medical Center, The Hague
N. J. van der Wee
Affiliation:
Psychiatry, Leiden University Medical Center
R. Fronczek
Affiliation:
Neurology, Leiden University Medical Center, Leiden Sleep-Wake Center, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede
M. de Leeuw
Affiliation:
Psychiatry, Leiden University Medical Center Outpatient clinic for Bipolar Disorder, GGZ Rivierduinen, Leiden, Netherlands
*
*Corresponding author.

Abstract

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Introduction

Cluster headache (CH) and bipolar disorder (BD) are cyclic disorders with shared clinical aspects, e.g. disturbed sleep patterns, response to lithium and a tendency to use illicit drugs.

Objectives

We investigated comorbidity of BD in patients with CH, prevalence of BD amongst CH family members, circadian aspects and use of illicit drugs.

Methods

Patients from the Leiden University Cluster headache neuro-Analysis program (LUCA) were screened cross-sectionally for BD online, using the Mood Disturbance Questionnaire (MDQ-NL) and Altman Self Rating Scale (ASRM-NL) and, if indicated, further evaluated with the Mini international neuropsychiatric interview (MINI). Circadian aspects were analyzed using the Circadian Type Inventory (CTI) and the Munich Chronotype Questionnaire (MCTQ).

Results

The life-time prevalence of BD in patients suffering from CH was 6.5%. Patients with comorbid BD (CH+BD) were more likely to have family members with BD (standardized OR= 1.50, 95% CI=1.15;1.95, p=0.003) and were more likely to suffer from chronic CH (OR=3.05 95% CI=1.18;7.87, p=0.02) after adjustment for age and sex. They also more often used illicit drugs, compared to patients with only CH. Circadian type and chronotype did not differ between the two groups after adjustment for confounders.

Conclusions

There is a high prevalence of BD in CH patients. CH+BD patients are more likely to have a positive family history for BD. CH+BD patients are more likely to suffer from chronic CH and more often use illicit drugs. In clinical practice it is important to screen for BD when treating patients with CH.

Disclosure of Interest

None Declared

Information

Type
Abstract
Information
European Psychiatry , Volume 68 , Special Issue S1: Abstracts of the 33rd European Congress of Psychiatry , April 2025 , pp. S594
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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