Personality Profile Predicts Chronicization of Migraine and Responsiveness to Treatment

BOSTON—Patients with chronic migraine have a higher incidence of comorbid personality disorders than do those with episodic migraine, according to a study presented by Renata Rao, MD, and colleagues from the Department of Neurology at Brescia University Hospital in Italy. Dr. Rao presented her team’s findings at the 59th Annual Meeting of the American Academy of Neurology.

Participants in the study were 160 patients (124 females and 36 males) who sought treatment at the Headache Centre of the Neurological Division at Brescia University Hospital. Patients ranged in age from 16 to 65, with a mean age of 38. Of the participants, 127 had been diagnosed with episodic migraine and 33 had chronic migraine. Patients were diagnosed using the 2004 International Head­ache Society classification criteria; personality was evaluated using the Minnesota Multiphasic Personality Inventory 2; data were gathered and analyzed using the STATA 8 statistic package.

In their study cohort, the researchers found an increased presence of depression, self-criticism, social isolation, introversion, family problems, and unresponsiveness to pharmacologic treatment in chronic migraine patients in comparison to those with episodic migraine.

CLUES TO A BIGGER MYSTERY

The researchers had hoped to discover the possible predictive personality traits for the transformation from episodic to chronic migraine. While the mechanism that causes transformation from episodic to chronic pattern of migraine attacks is unclear, previous reports have identified hypochondriasis, hysteria, anxiety, and depression as the most prevalent personality features in migraine patients.

Based on their findings, the researchers concluded that mood and somatoform disorders are risk factors for the chronicization of migraine. In addition, researchers found that these comorbidities tend to be resistant to pharmacologic treatment. They suggested that personality assessments be considered as an additional diagnostic tool in the management of chronic migraine patients.           

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