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Guerra F, Di Giacomo D, Ranieri J, Saporito G, Sucapane P, Totaro R, Pistoia F. Network analysis of negative emotions in patients with episodic migraine: need for a multidisciplinary perspective. Front Neurol 2024; 15:1418188. [PMID: 39015320 PMCID: PMC11249559 DOI: 10.3389/fneur.2024.1418188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/10/2024] [Indexed: 07/18/2024] Open
Abstract
Background Episodic migraine (EM) is the second most prevalent neurological disorder worldwide and is responsible for more disability than all other neurological disorders combined. Triggers for the development of migraine include, stress, emotional burden, low blood sugar levels, tobacco, skipped meals, anxious and depressive feelings. Migraine affects both children and adults, occurring three times more frequently in women than in men. Objective The aim of this study was to evaluate the psychological profile of EM patients and the relationship among negative emotions in EM patients, analyzing self-efficacy measures in pain management. Design We performed an observational study in 60 outpatients aged 18-55 years (mean age 33.8; SD ±10.4) with EM. Methods All patients have been enrolled at the Headache Center of the San Salvatore Hospital of L'Aquila. The assessment comprised five standardized psychological self-assessments investigating relevant emotional dimensions and pain self-efficacy, along with two questionnaires assessing migraine-related disability. A network analysis of negative emotions was performed to evaluate which emotional traits and relationships play a crucial role in pain coping and management. Results Our findings indicate that migraine significantly impairs the quality of life of patients in their daily lives. Over half of the patients reported experiencing severe disability, with negative emotions significantly influencing their ability to cope with pain and maintain productivity during migraine attacks. Dysphoric variables (irritability, interpersonal resentment, and surrender) were correlated with difficulties in emotion regulation ability and with the capacity of engaging in goal-directed behaviors despite experiencing pain. The ability to regulate one's emotions and manage dysphoria were positively correlated with pain self-efficacy, whereas positive mental health was associated with individuals' confidence in performing activities despite experiencing pain. Conclusion Negative emotions had a negative correlation with positive mental health and were linked to a lower capacity to carry out daily activities despite experiencing migraine pain. This suggests that psychological interventions could improve mental health and potentially surpassing the effects of pharmacological interventions alone in migraine management. An integrated, patient-centered approach may represent an effective paradigm to address and reduce the burden of migraine, leading to a reduction in healthcare costs.
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Affiliation(s)
- Federica Guerra
- Postgraduate School on Clinical Psychology, University of L’Aquila, L’Aquila, Italy
| | - Dina Di Giacomo
- Postgraduate School on Clinical Psychology, University of L’Aquila, L’Aquila, Italy
- Department of MESVA, University of L’Aquila, L’Aquila, Italy
| | - Jessica Ranieri
- Postgraduate School on Clinical Psychology, University of L’Aquila, L’Aquila, Italy
| | - Gennaro Saporito
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | | | | | - Francesca Pistoia
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
- San Salvatore Hospital, L’Aquila, Italy
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Albilali A, Al-Hashel J, Elchami Z, Al Rukn S, Al Madani AB, AlTunaiji M, Al Ali J, Fathy M, Joury J. Unmet Needs of Patients Living with Migraine in the Gulf Cooperation Council (GCC) Countries. Pain Ther 2024; 13:201-210. [PMID: 38280147 DOI: 10.1007/s40122-024-00576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/04/2024] [Indexed: 01/29/2024] Open
Abstract
The scale of migraine and its impact on the lives of patients in the Gulf Cooperation Council (GCC) countries may be underestimated by healthcare professionals and the public and unmet needs in the provision of migraine medical care may exist. This article reports the key outcomes from a meeting of migraine specialists and their patients organised by the Emirates Neurology Society to learn more about the patient diagnosis and treatment journey and the extent to which migraine affects daily life. Patient stories indicate that the burden of migraine is underestimated, migraine is not generally recognised as a disease, delayed and incorrect diagnoses are common, and that achieving symptom control is often more a question of good luck rather than good management. Disease awareness campaigns are recommended to elevate societal understanding of migraine and reduce stigma toward patients affected by migraine. Recommendations for an improved healthcare system experience for patients affected by migraine include education initiatives targeting patients and physicians as well as initiatives to address gaps in the diagnosis and treatment of migraine.
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Affiliation(s)
- Abdulrazaq Albilali
- Neurology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jasem Al-Hashel
- Department of Neurology, Ibn Sina Hospital, Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ziad Elchami
- Advanced Neuro-Musculoskeletal Care Center, Dr Samir Abbas Hospital, Jeddah, Saudi Arabia
| | - Suhail Al Rukn
- Department of Neurology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Abu Baker Al Madani
- Department of Neurology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Mohamed Fathy
- Pfizer Gulf FZ LLC, Atlas Building, Dubai Media City, P.O. Box 502749, Dubai, United Arab Emirates
| | - Jean Joury
- Pfizer Gulf FZ LLC, Atlas Building, Dubai Media City, P.O. Box 502749, Dubai, United Arab Emirates.
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Wang YF, Tzeng YS, Yu CC, Ling YH, Chen SP, Lai KL, Chen WT, Wang SJ. Sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache. J Headache Pain 2023; 24:145. [PMID: 37907887 PMCID: PMC10619252 DOI: 10.1186/s10194-023-01685-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE The present study aimed to compare sex differences in the clinical manifestations related to dependence behaviors in medication-overuse headache (MOH). METHODS Consecutive patients with newly diagnosed chronic migraine (CM) with and without MOH based on the Third Edition of International Classification of Headache Disorders (ICHD-3) were enrolled prospectively from the headache clinic of a tertiary medical center. Demographics and clinical profiles were collected by using a questionnaire, which included current use of tobacco, alcohol, and caffeinated beverages, the Leeds Dependence Questionnaire (LDQ), the Severity of Dependence Scale (SDS), the Headache Impact Test-6 (HIT-6), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS In total, 1419 CM patients (1135F/284 M, mean age 41.7 ± 13.9 years) were recruited, including 799 with MOH (640F/159 M, mean age 42.5 ± 13.2 years) (56.3%). Smoking was associated with an increased risk for MOH in men (odds ratio [OR] = 3.60 [95% confidence interval = 1.73-7.50], p = 0.001), but not in women (OR = 1.34 [0.88-2.04], p = 0.171) (p = 0.021 for interaction). Hypnotic use ≥ 3 days/week was a risk factor for MOH (OR = 2.55 [95% confidence interval = 2.00-3.24], p < 0.001), regardless of sex. By using receiver operating characteristics (ROC) curves, the cutoff scores of the LDQ for MOH were determined at 7 for women and 6 for men, and those for the SDS were 5 and 4, respectively (area under curve all ≥ 0.83). Among patients with MOH, the male sex was associated with a shorter latency between migraine onset and CM onset (12.9 ± 11.1 vs. 15.4 ± 11.5 years, p = 0.008), despite less average headache intensity (6.7 ± 1.9 vs. 7.2 ± 1.9, p = 0.005), functional impacts (HIT-6: 63.4 ± 8.3 vs. 65.1 ± 8.0, p = 0.009), and sleep disturbances (PSQI: 10.9 ± 4.4 vs. 12.2 ± 4.3, p = 0.001). CONCLUSIONS The current study identified an association between smoking and MOH in men, as well as sex-specific cutoffs of the LDQ and the SDS, for MOH. MOH was characterized by a shorter latency between migraine onset and CM onset in men and a more severe phenotype in women. Sex should be considered as an important factor in the evaluation of MOH.
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Grants
- 109-2314-B-075 -054 and 110-2314-B-075 -041 -MY3 Taiwan National Science and Technology Council
- 104-2314-B-010-015-MY2, 106-2321-B-010-009, 107-2321-B-010-001, 108-2321-B-010-014 -MY2, 108-2321-B-010 001, 108-2314-B-010-023-MY3, and 110-2321-B-010-005 Taiwan National Science and Technology Council
- V108C-092, V109C-096, V110C-111, V111C-161, V112C-078, and V112D67-003-MY3-1 Taipei Veterans General Hospital
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Affiliation(s)
- Yen-Feng Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan.
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yi-Shiang Tzeng
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
| | - Chia-Chun Yu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
| | - Yu-Hsiang Ling
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
| | - Shih-Pin Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Lin Lai
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Ta Chen
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Ministry of Health and Welfare Keelung Hospital, Keelung, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Bei-Tou District, No. 201, Sec. 2, Shi-Pai Road, Taipei, 11217, Taiwan.
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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