Frequency and impact of post-traumatic stress disorder and traumatic life events in patients with migraine.

Abstract

Introduction: Post-traumatic stress disorder (PTSD) has been proposed as a risk factor for chronification of migraine. The aim of this study was to investigate the frequency of PTSD and traumatic life events (TE) in patients with episodic (EM) and chronic migraine (CM) and their impact on clinical parameters, other comorbidities, and migraine biomarkers.

Material and methods: Patients with EM and CM according to the International Classification of Headache Disorders (third edition; beta version) were recruited at a headache unit and a primary care centre. We used questionnaires validated for research on PTSD, TEs, cranial autonomic symptoms, comorbidities (depression, anxiety, and fatigue), disability, migraine impact, and quality of life. Baseline serum levels of CGRP, VIP, and PACAP were determined by ELISA.

Results: The study included 116 patients: 35 with EM and 81 with CM. Nineteen presented refractory migraine. PTSD was detected in 23 patients (19.8%): 20 with CM and 3 with EM (chi-square: P = .046; Fisher T: P = .073). No significant differences were identified between the EM and CM groups for frequency of any TE nor the number of TEs per patient. A total of 5/19 patients with refractory migraine had experienced sexual violence (vs 2/97 with non-refractory migraine; P = .002). PTSD was associated with more autonomic symptoms; higher scores on anxiety, depression, and fatigue scales; and poorer quality of life; it did not change neuropeptide levels.

Conclusions: Our results suggest that PTSD is frequent in patients with migraine, and especially CM, in our setting; history of sexual violence is particularly frequent in patients with refractory migraine. PTSD has a negative impact on migraine, with higher numbers of comorbidities and poorer quality of life; therefore, further research is needed in this patient group.