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

Abstract

AbstractBackgroundPrior studies have established an association between a history of abuse and more severe migraine presentation.ObjectivesThis 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.MethodsPatients 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.ResultsA 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.ConclusionA 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.