Migraine is not a psychiatric disorder, although behavioral
factors can critically influence the onset and course of
headache episodes. Beginning in the 1950s, the conceptualization
of migraine as a psychophysiological disorder by Wolff1 and
others ultimately supplanted the earlier and purely psychogenic
or psychopathological view of migraine based on psychoanalytic
principles of psychosomatic medicine. Just the same, migraine
disproportionately presents comorbidly with a variety of
psychiatric illnesses. Identifying and managing comorbid illness
is essential and can prove challenging in the treatment of
migraineurs. Migraine affects approximately 12% of Americans
each year. It is 3 times more common among women than men (17.1%
vs 5.6%, respectively) and peaks in prevalence between ages 25
and 55.2 Whereas migraine often manifests as an episodic
disorder, migraine is now recognized as a chronic disease that
persists or progresses over time as a function of biological and
psychosocial risk factors.3 Depressive