Migraine tied to behavioral, psychological factors

Even in individuals without psychiatric comorbidities, specific behavioral and psychological factors are associated with migraine, according to a study published online Aug. 26 in The Journal of Headache and Pain.

Francesca Pistoia, M.D., Ph.D., from the University of L'Aquila in Italy, and colleagues investigated the relationship between psychological factors and migraine in individuals free of psychiatric comorbidities. The analysis included 65 women with episodic migraine (EM), 65 with chronic migraine (CM), and 65 healthy controls.

The researchers found that CM patients reported poorer overall sleep quality, more severe sleep disturbances, greater sleep medication use, higher daytime dysfunction, and more severe insomnia symptoms than controls. Compared with CM patients, EM patients showed better sleep quality and lower sleep disturbances and sleep medication use. However, EM patients had more severe daytime dysfunction and insomnia symptoms versus controls. CM patients showed greater trait anxiety and a higher level of general anxiety sensitivity than controls. A higher pain catastrophizing tendency, more severe feeling of helplessness, and more substantial ruminative thinking were seen with CM patients than with EM patients and healthy controls, while EM participants showed higher scores in these three dimensions than controls. The three groups showed similar decision-making styles, intolerance of uncertainty, strategies for coping with uncertainty, and depression severity.

"Proper identification of those factors is important to improve management of migraine through nonpharmacological strategies," the authors write.

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