论文部分内容阅读
Objectives.- To define predictors of migraine- related disability in patien ts with episodic and chronic migraine referred to a specialty migraine clinic, f ocusing on depressive symptoms and insecure attachment style that, because of th eir association with responses to pain and physical illness, might be predictive of greater migraine- related disability. Background.- The Migraine Disability Assessment questionnaire (MIDAS) has proved to be a reliable and easy- to- us e instrument to assess migraine- related disability. As clinicians are increasi ngly using MIDAS in their diagnostic and treatment decisions for patient care, a n understanding of the factors influencing migraine- related disability is esse ntial for a rationale use of such an instrument. Methods.- Two- hundred patien ts suffering from episodic migraine without aura (EM), and chronic migraine (CM) with and without medication overuse, and referred to a specialty headache clini c were evaluated using the MIDAS, the Beck Depression Inventory (BDI), and the A ttachment Style Questionnaire (ASQ). Diagnosis of episodic and chronic migraine was operationally defined according to the International Headache Society (IHS) and Silberstein- Lipton criteria. Results.- Multiple regression analysis showe d that, in the total sample, disability was higher in those patients with CM, mo re severe depressive symptoms, an insecure style of attachment (as reflected by a lower score on the ASQ confidence scale), and experiencing more severe headach e pain intensity. In the subgroup of patients with episodic migraine, an insecur e style of attachment emerged as the most significant predictor of disability (o ther significant predictors were female sex and number of headache days per mont h). In contrast, in the subgroup of patients with CM, the only significant predi ctor of the total MIDAS score was a greater severity of depressive symptoms. Con clusions.- Our findings demonstrate the relevance of attachment style, an endur ing psychological trait not evaluated in previous studies, in influencing the di sability level in patients with migraine and confirm the role of comorbid depres sive symptoms in modulating the impact of migraine on every day functioning.
Objectives.- To define predictors of migraine- related disability in patien ts with episodic and chronic migraine referred to a specialty migraine clinic, f ocusing on depressive symptoms and insecure attachment style that, because of eir association with responses to pain and physical illness, might be predictive of greater migraine- related disability. Background.- The Migraine Disability Assessment questionnaire (MIDAS) has proved to be a reliable and easy- to- us e instrument to assess migraine- related disability. As clinicians are increasi ngly using MIDAS in their diagnostic and treatment decisions for patient care, an understanding of the factors influencing migraine- related disability is esse ntial for a rationale use such an instrument. Methods- Two- hundred patien ts suffering from episodic migraine without aura (EM), and chronic migraine (CM) with and without medication overuse, and referred to a specialty headache clini c were evaluated using the MIDAS, the Beck D Epression Inventory (BDI), and the Atachment Style Questionnaire (ASQ). Diagnosis of episodic and chronic migraine was operationally defined according to the International Headache Society (IHS) and Silberstein- Lipton criteria. Results. - Multiple regression analysis showe d that, in the total sample, disability was higher in those patients with CM, mo re severe depressive symptoms, an insecure style of attachment (as reflected by a lower score on the ASQ confidence scale), and experiencing more severe headach e pain intensity. In the subgroup of patients with episodic migraine, an insecur e style of attachment emerged as the most significant predictor of disability (o ther significant predictors were female sex and number of headache days per monh h). In contrast, in the subgroup of patients with CM, the only significant predi ctor of the total MIDAS score was a greater severity of depressive symptoms. Con clusions .- Our findings demonstrate the relevance of attachment style, an endur ing psychological trait not evaluated in previous studies, in influencing the di sability level in patients with migraine and confirm the role of comorbid depres sive symptoms in modulating the impact of migraine on every day functioning.