Migraine burden can negatively affect overall health, relationships, and careers, according to study results recently published in Headache. Researchers also indicate that chronic migraine is associated with greater burden than episodic migraine.
This investigation was an analysis of the longitudinal Chronic Migraine Epidemiology and Outcomes study and included a cohort of 13,064 participants with either chronic (n=1120; 8.6%) or episodic (n=11,944; 91.4%) migraine (74.3% women; mean age, 41.3±14.3 years). Researchers used the Silberstein‐Lipton modification of the International Classification of Headache Disorders criteria to classify chronic vs episodic migraine and used the family burden module to determine the burden of migraine on finances and familial and romantic relationships. Investigators used descriptive statistics to examine variables of interest between men and women, participants with episodic and chronic migraine, and for the overall sample. For categorical variables, they assessed subgroup differences using the χ2 test.
Across the entire cohort, participants reported 4.9±6.1 mean monthly headache days; persons with episodic migraine reported 3.3±3.2 monthly headache days, and individuals with chronic migraine reported 21.4±4.9 monthly headache days. Women reported more mean monthly headache days than men (5.1±6.2 vs 4.1±5.7, respectively; P <.001). Baseline demographics differed significantly between episodic and chronic migraine respondents. Compared with participants with chronic migraine, participants with episodic migraine had a lower mean number of children, were less likely to be obese, were less likely to have an annual household income <$25,000, and were more likely to have a ≥4-year college degree (P <.001 for all). Among individuals not currently in a romantic relationship, 16.8% cited headache as an impacting factor (episodic: 15%; chronic: 37%), with chronic migraine more than twice as likely as episodic migraine to be cited as affecting the initiation and maintenance of a relationship (P <.001). Furthermore, 3.2% of respondents indicated delaying or choosing not to have children as a result of migraine (episodic: 2.6%; chronic: 9.6%; P <.001). Among the 13,061 reporting on the effect of migraine on their career, 32.7% reported a negative effect on ≥1 aspect of their career (episodic: 30.3%; chronic: 58.4%). Across the entire cohort, 32.1% reported concern for long-term financial security as a result of migraine (episodic: 29.7%; chronic: 57.4%).
Limitations to this study included a lack of validation of survey items, the use of self-reporting for data collection, a lack of measurement of migraine/headache among partners or offspring, and potential selection bias resulting from web survey nonresponse.
Respondents with migraine reported that “headaches negatively affected many important areas of their lives and perceived that their lives would be better or a lot better without migraine.” Increased migraine frequency affected relationships, family life, and careers, in particular, with chronic migraine associated with the greatest burden. Physicians should ensure they have a comprehensive understanding of the disease burden on individuals with migraine.
Disclosure: This clinical trial was supported by Allergan, Inc. Please see the original reference for a full list of authors’ disclosures.
Buse DC, Fanning KM, Reed ML, et al. Life with migraine: effects on relationships, career, and finances from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study [published online August 12, 2019]. Headache. doi:10.1111/head.13613