Evaluation of Attachment Style and Social Support in Patients With Severe Migraine. Applications in Doctor-Patient Relationships and Treatment Adherence

Abstract

Objectives: The aim of this observational study was to describe social support and patterns of attachment among patients with migraine. We hypothesized that in comparison to the general population, insecure attachment is overrepresented in migraine patients, and that these patients have less social support. We also aimed to study the specific relationship between attachment and social support. We hypothesized that patients with an insecure attachment style have less social support than patients with a secure attachment style.Methods: A total of 101 consecutive patients (88.1% women) aged between 25 and 60 (average age = 41.4) were recruited at the Specialized Center for the Consultation of Primary Headaches at the Regional University Hospital Center of Besançon (France). Migraine impact and disability were evaluated using the Headache Impact Test (HIT-6) questionnaire and Migraine Disability Assessment (MIDAS) questionnaire. Patients also completed several self-administered psychological questionnaires in their validated French versions: the Medical Outcome Survey 36-Item Short-Form Health Survey, the Cungi Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Relationship Scales Questionnaire and the Sarason's Social Support Questionnaire.Results: The distribution of attachment profiles was different from that of the general population, with an overrepresentation of insecure attachment styles (p = 0.018). Our study showed that migraine patients had less social support than the general population, both in terms of the number of people providing support (p = 0.002) and the level of satisfaction concerning this social support (p = 0.000). We also found that neither the number of available persons score nor the satisfaction score were statistically different between the four attachment categories (p = 0.49). Patient's attachment style and social support influence the patient-doctor relationship, the therapeutic alliance and health behaviors such as treatment adherence.Conclusions: Based on the data we obtained, we developed applications in patient care for people with particular attachment styles and low social support. A treatment plan adapted to the patient's attachment profile should be created to develop “precision medicine” using a personalized approach to the doctor-patient relationship. We would also recommend encouraging patients to participate in support groups, in order to strengthen their attachment systems and gain social support.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03577548, identifier NCT03577548.

Social cognition in Chronic Migraine with Medication Overuse: Do you mind what I think?

“…By contrast, it has been shown that headache sufferers had slightly more social support from their families than non-headaches sufferers [75]. Hence, it is di cult to draw de nitive conclusions given the heterogeneity of the clinic populations [70][71][72][73]75]. However, our results suggest that CM + MO patients place importance on tangible support from their family members, although they do not feel much satis ed with the support received from social networks [70,76,77].…”

“…The topic of social relationships in migraine is much debated. There is evidence reporting that migraine patients are less satis ed with social support than the general population [70][71][72]. Belot [72] found that patients with severe migraine judged the social support they received worse than the general population did.…”

“…There is evidence reporting that migraine patients are less satis ed with social support than the general population [70][71][72]. Belot [72] found that patients with severe migraine judged the social support they received worse than the general population did. Others [73] reported that poor social support and loneliness in CM were associated with a tendency to MO.…”

Problems in management of medication overuse headache in transgender and gender non-conforming populations

“…Although online relationships are generally a poor substitute for the possible benefits gained from physical relationships, online discussions about chronic illness with other patients may provide better support and resources that are then crucial to restore patient self-esteem, personal identity, and self-advocacy ( 28 ). Belot et al ( 27 ) reported that migraineurs were more likely to have an insecure attachment style, fewer people included in their social networks, and less satisfaction obtained from social connections than the general population; therefore, successful chronic pain management requires coping skills to navigate the emotional trauma of chronic pain and reduce the risk of mental illness.…”

Different Aspects of Aging in Migraine

“…There are other aspects of social aging that are reported to be associated with migraine. It was hypothesized that insecure attachment was overexpressed in migraine patients and these patients had less social support as compared with general population [ 63 ]. This hypothesis was verified in a study with 101 consecutive patients evaluated with a battery of tests and questionnaires.…”