Impaired Functioning and Quality of Life in Severe Migraine: The Role of Catastrophizing and Associated Symptoms

Abstract

Migraine characteristics are associated with impaired functioning and quality of life (Fn/QoL), but the impact of other factors on Fn/QoL in headache patients is largely unexplored. We examined catastrophizing, comorbid anxiety/depression and migraine characteristics as related to Fn/QoL, and explored the consistency of these relationships across five Fn/QoL measures. We evaluated 232 frequent migraine sufferers for comorbid psychiatric diagnosis, and they completed anxiety, depression and catastrophizing measures, recorded migraine characteristics in a diary and completed five Fn/QoL measures (four self-report questionnaires, one diary disability measure). Backward regression revealed catastrophizing and severity of associated symptoms (photophobia, phonophobia, nausea) independently predicted Fn/QoL across all five measures (β weights 0.16-0.50, all P < 0.01). This is the first demonstration that a psychological response to migraines (catastrophizing) is associated with impaired Fn/QoL independent of migraine characteristics and other demographic and psychological variables. Severity of associated symptoms also emerged as an important contributor to Fn/QoL.

Behavioral medicine for migraine and medication overuse headache

“…CBT also may focus on changing "catastrophizing," a hopeless and overwhelming thinking pattern that has been shown to predict poor outcome and reduced quality of life. Holroyd et al [35] examined catastrophizing, comorbid anxiety, depression, quality of life, and headache characteristics among 232 migraine sufferers and found that catastrophizing and severity of associated symptoms (photophobia, phonophobia, nausea) independently predicted quality of life; these outcomes demonstrated that it is not just headache severity and frequency that predict quality of life, but that patient perception is directly related to quality of life. Other targets of CBT include assertiveness training, increased coping and problem-solving skills, and cognitive restructuring.…”

Case Report Unruptured saccular aneurysm presenting migraine

“…The patient was examined with follow-up for 8 months after stent-assisted coil embolization of the aneurysm, and no recurrent episode of headache was noted. To our knowledge, no similar case has been reported in the literature (Bigal et al, 2004;Holroyd et al, 2007;Brandes, 2008;Wang et al, 2008); thus, further study is required to explore the underlying mechanisms involved. Early diagnosis and aggressive intervention may not only reduce the risk of the aneurysmal rupture, but also effectively control headache.…”

Research Note Clinical reports and analysis of patients with clinical manifestations of migraine-like headache and unruptured aneurysm

“…They were examined with follow-up for 17, 13, and 23 months, respectively, after the stent-assisted coil embolization of the aneurysm, and no recurrent episodes of headache were noted. At present, the pathogenesis of migraine is not entirely clear, with the trigeminal nerve vascular theory predominating (Holroyd et al, 2007;Silberstein, 2009). According to this theory, migraine is due to the dysfunction of the endogenous sensory modulation system in both the trigeminal vascular (through 5-HT1B/1D receptor modulators) and central nervous systems, plus excessive external stimulation.…”