study had a three-fold higher likelihood of comorbid hypothyroidism compared to males. Migraines also had a remarkable association in females with bipolar disease in our study; they were three times more likely to have migraines as a comorbidity than males. There exists a higher percentage of the co-occurrence of migraines and bipolar disorders, predominantly in subjects with a confirmed family history of bipolar disorder, suicidal attempts and childhood physical abuse [19]. In addition to the higher prevalence ranging from 30 to 34.8% [20,21], patients with bipolar disorders and migraines were also found to have a complex course of the disease with more severe and an increased number of depressive episodes, as well as suicidality [22]. Oxidative stress and inflammation in cross sensitization between bipolar disorder and migraine has been hypothesized as a possible explanation [22]. Genetic factors are also thought to be implicated in the co-occurrence of migraine and bipolar disorders. In addition, inflammatory mechanisms involving abnormal cytokine activation and abnormal arachidonic acid metabolism have also been postulated as a common pathogenesis [23]. Both of these disorders also demonstrated higher neuroticism, which might, in part, explain the co-occurrence [23]. Similar to that seen in our study, the prevalence of migraine
