By Will Boggs, MDNEW YORK (Reuters Health) Jun 23 - Migraine headache is commonly associated with and clinically more serious in bipolar disorder, according to a report in the June issue of Headache."Given the high rates of bipolar disorder and migraine in primary care, I think it is entirely reasonable to recommend screening for bipolar disorder in any patient presenting with affective symptoms and migraine phenotype," Dr. Roger S. McIntyre from University of Toronto told Reuters Health.Dr. McIntyre and colleagues investigated the occurrence of bipolar disorder and migraine headache among close to 37,000 respondents to the Canadian Community Health Survey-Mental Health and Well-Being.Nearly 15% of men and 34.7% of women with bipolar disorder reported a diagnosis of migraine headache, the authors report, compared with 5.8% of men and 14.7% of women without bipolar disorder.Men with bipolar disorder and migraine were more likely than men with bipolar disorder alone to live in a low-income household and receive welfare and guaranteed income supplement and other social assistance as their main source of income, the results indicate. Men with bipolar disorder and migraine were also more likely to report an earlier average of onset, to report a lifetime comorbid anxiety disorder, and to take multiple medications.Women with bipolar disease and migraine were more likely than women with bipolar disorder alone to report a need for help with activities of daily living and to report "fair" or "poor" health versus more positive dimensions of overall health, the researchers note."Our data indicate that migraine comorbidity may identify a sub-phenotype of bipolar disorder," Dr. McIntyre said. "More specifically, individuals with bipolar disorder appear different on several indices of illness severity. We will try to replicate this result in a separate large clinical cohort."He suggests that clinicians should "familiarize themselves with proven treatments of bipolar disorder that are also effective in migraine."Headache 2006;46:973-982.