A history of abuse is associated with more severe migraine‐ and pain‐related disability: Results from the American Registry for Migraine Research.

Trivedi, Meesha; Dumkrieger, Gina; Chong, Catherine D.; Leibovit‐Reiben, Zachary; Schwedt, Todd J.

Background: Prior studies have established an association between a history of abuse and more severe migraine presentation. Objectives: This cross‐sectional, observational study of a clinic‐based migraine population used validated measures to elucidate migraine‐specific and migraine‐related burdens among patients with a history of abuse. Methods: Patients with migraine (n = 866) from the American Registry for Migraine Research self‐reported if they had a history of emotional, physical, and/or sexual abuse and completed questionnaires assessing migraine‐related burden: Migraine Disability Assessment, Subjective Cognitive Impairment Scale for Migraine Attacks, Work Productivity and Activity Impairment, Patient‐Reported Outcomes Measurement Information System Pain Interference, Patient Health Questionnaire‐2, and Generalized Anxiety Disorder‐7. Migraine‐related burden in patients with versus without a history of abuse was compared. Subsequently, a mediation analysis evaluated the impact of depression and anxiety symptoms in the relationship between abuse history and migraine burden. Results: A history of abuse was reported by 36.5% (n = 316/866) of participants. After controlling for patient age, sex, years lived with headache, and headache frequency, a history of abuse was significantly associated with more severe migraine‐related disability. The combined burden of depression and anxiety symptoms mediated the relationship. Conclusion: A history of abuse is associated with greater migraine‐related disability. Future studies should determine if identification and management of the psychological and physical sequelae of abuse reduce migraine burden. Plain Language Summary: In this study, we found that patients with migraine who participated in the American Registry for Migraine Research and self‐reported a history of emotional, physical, or sexual abuse had worse migraine‐related burden than patients with migraine without a history of abuse. For example, patients who are survivors of abuse described a greater impact of migraine on their work, day‐to‐day living, and cognition. This increased migraine burden may be because of depression and anxiety, and we wonder if treating the underlying causes of these mental health difficulties might reduce their migraine burden.

UNITED States; DISABILITIES; CROSS-sectional method; SELF-evaluation; LABOR productivity; RESEARCH funding; CHILD abuse; PSYCHOLOGY of adult child abuse victims; SCIENTIFIC observation; QUESTIONNAIRES; HEADACHE; SEVERITY of illness index; DESCRIPTIVE statistics; ANXIETY; SYMPTOM burden; CHILD sexual abuse; COGNITION disorders; PSYCHOLOGICAL abuse; PSYCHOLOGICAL tests; COMPARATIVE studies; FACTOR analysis; MIGRAINE; ACTIVITIES of daily living; MENTAL depression; ASSAULT & battery; EVALUATION

Headache: The Journal of Head & Face Pain, 2024, Vol 64, Issue 9, p1109

0017-8748

Academic Journal

10.1111/head.14787