Women With Chronic Migraine May Have Unique Behavioral and Psychological Traits

Chronic migraine in women without psychiatric comorbidities is tied to behavioral and psychological factors.

Behavioral and psychological factors may be important contributors to and potential modifiable factors of migraine in women, according to study findings published in The Journal of Headache and Pain.

Patients with migraine often report sleep disorders, depression, and anxiety. A strong bidirectional relationship between migraine and psychiatric disorders is also well documented. Despite these relationships, there is limited awareness of specific psychological traits in migraine. However, increasing awareness may help inform clinical decisions about nonpharmacological treatment approaches.

Researchers recruited women (n=181) referred to the Headache Center of L’Aquila/Avezzano in Italy for episodic (n=116) or chronic (n=65) migraine and healthy control individuals (n=65) for this study. Participants underwent a self-reported neuropsychological assessment for approximately 40 minutes. Trends in behaviors and psychological factors were compared between groups.

Individuals in the episodic migraine cohort were mean age, 43.9±7.2 years, the patients with chronic migraine were mean age, 47.7±8.5 years, and control individuals were mean age, 43.5±9.0 years.

Compared with control individuals, those in the episodic migraine group reported greater daytime dysfunction (P <.01), more insomnia symptoms, higher pain catastrophizing, helplessness, and rumination (all P <.05) scores.

Proper identification of those factors is important to improve management of migraine through non-pharmacological strategies.

Individuals in the chronic migraine group scored higher than control individuals on sleep quality, sleep disturbance, insomnia symptoms, cognitive concerns, anxiety, pain catastrophizing, helplessness, rumination (all P <.001), sleep medications, physical concerns (both P <.01), daytime dysfunction, and anxiety sensitivity (both P <.05) scores.

Compared between patient groups, those in the chronic migraine cohort had elevated scores for sleep disturbances, sleep medications, pain catastrophizing, helplessness (all P <.01), sleep quality, cognitive concerns, and rumination (all P <.05) compared with the episodic migraine group.

The results of this study may not be generalizable for an older population or for men with migraine.

These data indicated that patients with migraine exhibited specific behavioral and psychological traits that differed from non-migraine control individuals. “Proper identification of those factors is important to improve management of migraine through non-pharmacological strategies,” the researchers concluded.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Pistoia F, Salfi F, Saporito G, et al. Behavioral and psychological factors in individuals with migraine without psychiatric comorbidities. J Headache Pain. 2022;23(1):110. doi:10.1186/s10194-022-01485-x