Recalled maltreatment, migraine, and tension-type headache: results of the AMPP study

Gretchen E Tietjen, Dawn C Buse, Kristina M Fanning, Daniel Serrano, Michael L Reed, Richard B Lipton
Neurology 2015 January 13, 84 (2): 132-40

OBJECTIVE: To examine the relationship of recalled adverse childhood experiences (ACEs) with migraine and episodic tension-type headache (ETTH).

METHODS: We conducted a cross-sectional analysis of ACEs among 2007 American Migraine Prevalence and Prevention Study survey respondents with ETTH and migraine. We modeled headache type using logistic regression adjusting for sociodemographic variables (age, race, sex, income), depression, and anxiety, and headache day frequency using ordinal logistic regression with a proportional odds model.

RESULTS: Participants had migraine (n = 8,305) or ETTH (n = 1,429). Rates of ACEs were significantly higher among respondents with migraine than ETTH for emotional neglect (24.5% vs 21.5%), emotional abuse (22.5% vs 16.7%), and sexual abuse (17.7% vs 13.3%). Odds of migraine vs ETTH were significantly higher for those reporting emotional neglect (odds ratio [OR] = 1.23, 95% confidence interval [CI] 1.07-1.42), emotional abuse (OR = 1.46, 95% CI 1.25-1.71), or sexual abuse (OR = 1.35, 95% CI 1.11-1.62) when adjusted for sociodemographics. Results remained significant only for emotional abuse when adjusting for depression and anxiety (OR = 1.33, 95% CI 1.13-1.57). Odds of migraine were higher with 2 (OR 1.52, 95% CI 1.25-1.86) vs 1 (OR 1.17, 95% CI 1.00-1.36) ACE, which held after adjusting for depression and anxiety. All forms of maltreatment were associated with higher headache day frequency category in migraine but results lost significance after adjusting for depression and anxiety.

CONCLUSIONS: ACEs are associated with a higher risk of migraine vs ETTH. Attenuation of the influence of ACEs by depression and anxiety suggests confounding or mediation, although results for emotional abuse were generally maintained.


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