Smile: First Observational Prospective Cohort Study of Migraine in Primary Care in France. Description of Methods and Study Population

Abstract

The SMILE study was conducted among migraine patients consulting in primary care in France. The first phase aimed to describe the study sample of patients at entry to the study, especially emotional dimension (Hospital Anxiety and Depression scale), functional impact (abridged Migraine Specific Questionnaire), stress (Perceived Stress Scale) and coping behaviours (brief COPE inventory avoidance subscale, Coping Strategies Questionnaire catastrophizing subscale), as well as treatments used and their effectiveness and treatments prescribed at end of consultation. Results indicate that consulting migraine patients suffer frequent migraine attacks, exhibit substantial levels of anxiety, functional impact and stress, and often use maladaptive coping strategies. Abortive treatments appear ineffective in most patients (74%). Patients with more affected psychometric variables and treatment ineffectiveness are more likely to be deemed eligible for prophylactic treatment. These data highlight the seriousness of migraine and maladjustment of patients consulting in primary care.

Negative Affectivity, Emotion Regulation, and Coping in Migraine and Probable Migraine: A New Zealand Case–Control Study

“…A recent study of acceptance in migraineurs found that greater acceptance of migraine-related pain predicted lower disability/interference with life [60]; however, another study of migraineurs in France showed that dispositional acceptance coping was associated with poorer outcomes [61]. Similarly, dispositional behavioural disengagement was shown to be higher among migraineurs reporting more severe/frequent symptoms [28]. This may suggest differences in the types of characteristics indexed by dispositional measures versus pain-specific measures.…”

“…Behavioural disengagement (i.e. 'giving up') appears more common among migraineurs with more severe/frequent symptoms [28], and passive coping predicts eligibility for prophylactic treatment (indicating more frequent and debilitating migraines; see also [29]). The tendency to seek (monitoring) or avoid (blunting) health information may also be relevant.…”

Association between migraine, anxiety and depression

“…Epidemiological studies have shown that migraine is comorbid with a number of psychiatric disorders, including generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder, bipolar disorder and personality disorders (10)(11)(12)(13)(14)(15)(16)(17)(18). A recent Canadian health survey reported that MDD, social phobia and panic disorder were significantly more common in migraineurs than in non-migraineurs, with odds ratios (OR) of 2.3 [95% confidence interval (CI) 1.9, 2.8], 2.3 (95% CI 1.9, 2.9) and 2.8 (95% CI 2.2, 3.6), respectively (18).…”

Patient outcome in migraine prophylaxis: the role of psychopharmacological agents

“…Géraud et al found that the majority of 5,417 migraine patients exhibited significant psychological symptoms, and most of patients were classified as anxious 38. Two-thirds of patients (67%) suffered from anxiety (28% from anxiety alone, 39% from anxiety and depression), and 2% from depression alone.…”