Psychological Factors Associated With Chronic Migraine and Severe Migraine-Related Disability: An Observational Study in a Tertiary Headache Center

Elizabeth K. Seng, Dawn C. Buse, Jaclyn E. Klepper, Sarah J. Mayson, Amy S. Grinberg, Brian M. Grosberg, Jelena M. Pavlovic, Matthew S. Robbins, Sarah E. Vollbracht, Richard B. Lipton

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To evaluate the relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background: Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods: Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score≥21), and modifiable psychological factors (depressive symptoms [Patient Health Questionnaire-9], anxious symptoms [Generalized Anxiety Disorder-7], Pain Catastrophizing Scale and Headache Specific Locus of Control). Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results: Among 90 eligible participants the mean age was 45.0 (SD=12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR=1.99, 95% CI=1.11, 3.55) and chance HSLC (OR=1.85, 95% CI=1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR=3.54, 95%CI=1.49, 8.41), anxiety symptoms (OR=3.65, 95% CI=1.65, 8.06), and pain catastrophizing (OR=1.95, 95% CI=1.14, 3.35), were associated with severe migraine-related disability. Conclusions: Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate the relationships among naturalistic variation in psychological factors, migraine-related disability, and migraine chronification.

Original languageEnglish (US)
JournalHeadache
DOIs
StateAccepted/In press - 2017

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Migraine Disorders
Observational Studies
Headache
Psychology
Catastrophization
Depression
Internal-External Control

Keywords

  • Anxiety
  • Catastrophizing
  • Chronic migraine
  • Depression
  • Disability
  • Locus of control
  • Migraine

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Psychological Factors Associated With Chronic Migraine and Severe Migraine-Related Disability : An Observational Study in a Tertiary Headache Center. / Seng, Elizabeth K.; Buse, Dawn C.; Klepper, Jaclyn E.; J. Mayson, Sarah; Grinberg, Amy S.; Grosberg, Brian M.; Pavlovic, Jelena M.; Robbins, Matthew S.; Vollbracht, Sarah E.; Lipton, Richard B.

In: Headache, 2017.

Research output: Contribution to journalArticle

Seng, Elizabeth K. ; Buse, Dawn C. ; Klepper, Jaclyn E. ; J. Mayson, Sarah ; Grinberg, Amy S. ; Grosberg, Brian M. ; Pavlovic, Jelena M. ; Robbins, Matthew S. ; Vollbracht, Sarah E. ; Lipton, Richard B. / Psychological Factors Associated With Chronic Migraine and Severe Migraine-Related Disability : An Observational Study in a Tertiary Headache Center. In: Headache. 2017.
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abstract = "Objective: To evaluate the relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background: Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods: Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score≥21), and modifiable psychological factors (depressive symptoms [Patient Health Questionnaire-9], anxious symptoms [Generalized Anxiety Disorder-7], Pain Catastrophizing Scale and Headache Specific Locus of Control). Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results: Among 90 eligible participants the mean age was 45.0 (SD=12.4); 84.8{\%} were women. One-third (36.0{\%}) met study criteria for chronic migraine; half of participants (51.5{\%}) reported severe migraine-related disability. Higher depressive symptoms (OR=1.99, 95{\%} CI=1.11, 3.55) and chance HSLC (OR=1.85, 95{\%} CI=1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR=3.54, 95{\%}CI=1.49, 8.41), anxiety symptoms (OR=3.65, 95{\%} CI=1.65, 8.06), and pain catastrophizing (OR=1.95, 95{\%} CI=1.14, 3.35), were associated with severe migraine-related disability. Conclusions: Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate the relationships among naturalistic variation in psychological factors, migraine-related disability, and migraine chronification.",
keywords = "Anxiety, Catastrophizing, Chronic migraine, Depression, Disability, Locus of control, Migraine",
author = "Seng, {Elizabeth K.} and Buse, {Dawn C.} and Klepper, {Jaclyn E.} and {J. Mayson}, Sarah and Grinberg, {Amy S.} and Grosberg, {Brian M.} and Pavlovic, {Jelena M.} and Robbins, {Matthew S.} and Vollbracht, {Sarah E.} and Lipton, {Richard B.}",
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journal = "Headache",
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T1 - Psychological Factors Associated With Chronic Migraine and Severe Migraine-Related Disability

T2 - An Observational Study in a Tertiary Headache Center

AU - Seng, Elizabeth K.

AU - Buse, Dawn C.

AU - Klepper, Jaclyn E.

AU - J. Mayson, Sarah

AU - Grinberg, Amy S.

AU - Grosberg, Brian M.

AU - Pavlovic, Jelena M.

AU - Robbins, Matthew S.

AU - Vollbracht, Sarah E.

AU - Lipton, Richard B.

PY - 2017

Y1 - 2017

N2 - Objective: To evaluate the relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background: Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods: Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score≥21), and modifiable psychological factors (depressive symptoms [Patient Health Questionnaire-9], anxious symptoms [Generalized Anxiety Disorder-7], Pain Catastrophizing Scale and Headache Specific Locus of Control). Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results: Among 90 eligible participants the mean age was 45.0 (SD=12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR=1.99, 95% CI=1.11, 3.55) and chance HSLC (OR=1.85, 95% CI=1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR=3.54, 95%CI=1.49, 8.41), anxiety symptoms (OR=3.65, 95% CI=1.65, 8.06), and pain catastrophizing (OR=1.95, 95% CI=1.14, 3.35), were associated with severe migraine-related disability. Conclusions: Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate the relationships among naturalistic variation in psychological factors, migraine-related disability, and migraine chronification.

AB - Objective: To evaluate the relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background: Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods: Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score≥21), and modifiable psychological factors (depressive symptoms [Patient Health Questionnaire-9], anxious symptoms [Generalized Anxiety Disorder-7], Pain Catastrophizing Scale and Headache Specific Locus of Control). Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results: Among 90 eligible participants the mean age was 45.0 (SD=12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR=1.99, 95% CI=1.11, 3.55) and chance HSLC (OR=1.85, 95% CI=1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR=3.54, 95%CI=1.49, 8.41), anxiety symptoms (OR=3.65, 95% CI=1.65, 8.06), and pain catastrophizing (OR=1.95, 95% CI=1.14, 3.35), were associated with severe migraine-related disability. Conclusions: Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate the relationships among naturalistic variation in psychological factors, migraine-related disability, and migraine chronification.

KW - Anxiety

KW - Catastrophizing

KW - Chronic migraine

KW - Depression

KW - Disability

KW - Locus of control

KW - Migraine

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