Anxiety, Depression Mediate Association Between Illness Perception and Job Fulfillment in Chronic Migraine

Many patients with HIV also experience chronic pain
Many patients with HIV also experience chronic pain
Results suggest that it is important to develop interventions aimed at improving the quality of life in individuals with chronic migraine and to increase knowledge about headache and psychological consequences.

Anxiety and depression play mediating effects on the association between illness perception and job fulfillment in patients with chronic migraine treated with OnabotulinumtoxinA, according to study findings published in Headache.

Study investigators enrolled a total of 98 patients with chronic migraine who were treated with OnabotulinumtoxinA at the Regional Referral Headache Centre of Sant’Andrea Hospital in Rome, Italy. Only patients who were able to carry on a conversation and demonstrate full cognitive skills were included in the study. Participants completed a socio-anamnestic form (collecting information on age, sex, marital status, education level, etc) as well as the Brief Illness Perception Quality of Life, Enjoyment and Satisfaction Questionnaire, State-Trait Anxiety Inventory, and Beck Depression Inventory-II.

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The first mediational model demonstrated that illness perception positively correlated with trait anxiety (b = 0.522; 95% CI, 0.32-0.72) and depressive symptoms (b = 0.439, 95% CI, 0.28-0.61). Depressive symptoms (b = −0.424, 95% CI, −0.69 to −0.11]) and trait anxiety (b = −0.415, 95% CI, −0.63 to −0.18) were negatively associated with job satisfaction. Illness perception had a negative association with job satisfaction, which was mediated by depressive symptoms (ab = −0.186; 95% CI, −0.33 to −0.04).

Limitations of the study include its predominately female population (n=85), small number of participants, recruitment of patients from a single center, and the reliance on self-report for data collection.

The researchers concluded that useful initiatives could “carry out an intervention focused on improving realistic and adaptive illness perception and reduce anxiety and depressive symptoms in order to enhance the quality of life, including gratification derived by work.”

Disclosure: Paolo Martelletti has received educational grants, honoraria, travel grants, fees for lectures from ACRAF, Allergan, Novartis, TEVA, SpringerOpen.


Rogante E, Sarubbi S, Lamis DA, et al. Illness perception and job satisfaction in patients suffering from migraine headaches: trait anxiety and depressive symptoms as potential mediators. Headache. 2019;59(1):46-55.