Abstract
BackgroundHeadache chronicity has been known to elicit deleterious effects on quality of life (QOL). We evaluated the contribution of headache chronicity to QOL in relation to clinical, psychiatric, and psychosocial variables in patients with migraine.MethodsSubjects were recruited from a headache clinic and completed self-report questionnaires including the Migraine Disability Assessment (MIDAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Migraine-Specific Quality of Life (MSQoL). We obtained predictors of MSQoL by multiple regression analyses. A path analysis model was constructed to analyze interrelationships between the variables.ResultsAmong 251 eligible patients, 183 (72.9%) had episodic migraine (EM) and 68 (27.1%) had chronic migraine (CM). Patients with CM had more serious clinical, psychiatric, and poor QOL than did patients with EM. The strongest predictor of the MSQoL score in all patients with migraine was the BDI score (β = -0.373, p < 0.001), followed by the MIDAS score (β = -0.223, p < 0.001), female gender (β = -0.192, p < 0.001), attack duration (β = -0.159, p = 0.001), and headache chronicity (β = -0.130, p = 0.012). Headache chronicity had a direct effect on the MSQoL score and exerted an indirect effect on the MSQoL score through the MIDAS and the BDI scores.ConclusionsChronic migraine appears to impair QOL directly as well as indirectly by provoking disability and depression.
Highlights
Headache chronicity has been known to elicit deleterious effects on quality of life (QOL)
Based on a review of previous studies [12,14,17,19,20,22,23,24], we developed a hypothetical model outlining the path of depression, migraine disability, gender, attack duration, headache chronicity, and gender to QOL
Patients with chronic migraine (CM) had a lower level of education (p = 0.002), higher attack frequency (p < 0.001), higher VASnow score (p < 0.001), and higher frequency of cephalic allodynia (p = 0.03), than those with episodic migraine (EM)
Summary
Headache chronicity has been known to elicit deleterious effects on quality of life (QOL). Migraine should be considered among the most disabling of diseases [1]. Migraine is a common neurological disorder, with 1-year prevalence ranging from 4.5% to 8% for men, and from 8% to 16% for women [3,4,5]. In the American Migraine Prevalence and Prevention (AMPP) study, patients with CM had 2 times higher developing depression, anxiety, and chronic pain than those with EM [14]. The International Burden of Migraine Study (IBMS) collected data from several countries in Western Europe, North America and the Asia/Pacific regions, and reported that patients with CM demonstrated greater disability, a lower quality of life (QOL), and higher levels of anxiety and depression, than those with EM [12,13]. CM and depression are known risk factors for suicide behavior or ideation in patients with migraine [15,16]
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