Association Between Intimate Partner Violence, Migraine and Probable Migraine

Abstract

Objective Intimate partner violence (IPV) among women is a global public health problem. The association between childhood maltreatment and migraine is well established, but not the association between IPV and migraine. The aim of this cross-sectional study was to evaluate the relationship between type and severity of IPV and migraine in a large cohort of Peruvian women. Methods Women who delivered singleton infants (N=2,066) at the Instituto Nacional Materno Perinatal, Lima, Peru were interviewed during their post-partum hospital stay. Participants were queried about their lifetime experiences with headaches and migraine, and with physical and sexual violence. The International Classification of Headache Disorders (ICHD-2) diagnostic criteria were used to classify participants according to their migraine status. Questions on physical and sexual violence were adapted from the protocol of Demographic Health Survey Questionnaires and Modules: Domestic Violence Module and the World Health Organization (WHO) Multi-Country Study on Violence against Women. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire Depression Subset. Logistic regression was used to estimate multivariate adjusted odds ratios (aOR) and 95% confidence intervals (CI). Results Compared with women without a history of violence, women with experiences of lifetime physical or sexual violence (aOR=1.44, 95% CI 1.19–1.75), physical violence only (aOR=1.36, 95% CI 1.10–1.68), sexual violence only (aOR=1.76, 95% CI 0.97–3.21) and both physical and sexual violence (aOR=1.61, 95% CI 1.12–2.31) had increased odds of any migraine after adjusting for maternal age, parity and access to basic foods. There was no gradient of increased odds of any migraine with severity of physical violence. The relationship between IPV and any migraine was strongest among women with depressive symptoms. The odds of any migraine was increased 2.25-fold (95% CI 1.75–2.28) among abused women who also had depressive symptoms compared with non-abused and non-depressed women. Associations from sensitivity analyses that segregated women according to probable migraine (ICHD-2 category 1.6.1) and migraine (ICHD-2 category 1.1) diagnoses were of similar magnitudes as those reported here for women with any migraine diagnoses. IPV, particularly sexual violence, appears to be a risk factor for migraine. Conclusion Our findings suggest the potential importance of considering a history of violence among migraineurs.

The American Academy of Neurology position statement on abuse and violence

“…20 The short-and long-term consequences of adverse childhood experiences, including abuse and neglect, can result in a multitude of physical and social problems. 22 Headaches, [23][24][25][26][27][28] fibromyalgia, chronic pain syndromes, syncope, and psychogenic nonepileptic seizure have been linked to abuse. 29 -32 In addition, adults who were exposed to parental verbal abuse experienced higher rates of depression, irritability, and somatization.…”

Posttraumatic Stress Disorder and Intimate Partner Violence in a Women's Headache Center

“…However, that study did not use standardized measures of abuse, making the results difficult to generalize. A recent study of post-partum hospitalized women in Peru found that 34.8% of migraine sufferers reported a lifetime history of IPV (Cripe et al, 2011). Neither of these studies ascertained recent or 12-month prevalence rates of IPV in the populations studied.…”

“…Abused women have 1.5 to 2 times higher risk of chronic pain, including headache (Coker et al, 2002) (see Figure 1). Women who are victims of IPV are up to 60% more likely to suffer from headache than unabused controls (Coker et al, 2002;Cripe et al, 2011). A retrospective chart review of mostly female (90.1%) tertiary care headache patients in the United States found that nearly 35% reported a lifetime history of physical and/or sexual abuse (Peterlin et al, 2007).…”

Factores asociados a violencia física reciente de pareja hacia la mujer en el Perú, 2004-2007

“…Existe evidencia de las graves consecuencias, directas e indirectas, que ocasiona la violencia de pareja en la salud de la mujer (2)(3)(4)(5) . La prevalencia de violencia física o sexual contra la mujer por la pareja es alta aunque puede variar según los ámbitos geográficos.…”

“…Prevalence of physical violence at the national level was 14,5%, with variations according to the geographical areas (9,7% to 18,9%). The factor associated to a higher risk is having a couple who frequently gets drunk (OR: 7,2; 95%CI: 5,4-9,6) and having a couple controlling or limiting the woman's visits to family or friends (OR: 4,1; 95%CI: 3,(3)(4)(5)0); other associated factors are history of physical aggression of the father to the mother, having had previous partners, be cohabiting, having a higher educational level than the partner and having a disbalanced decision taking in the couple. Among the factors associated with a lower risk are the communication and respect inside the couple (OR: 0,3; 95%CI: 0,2-0,3), and the fact that the woman has health insurance.…”