Background & Aims
Migraine is a prevalent and disabling neurological disorder that impacts 1/10 youth. Research has shown that youth with migraine are at higher risk of internalizing mental health symptoms (e.g., anxiety, depression) and pain catastrophizing compared to youth without migraine. However, there remains a notable gap whether mental health symptoms and migraine outcomes are temporally or causally related. In particular, the dynamic, day-to-day associations among mental health symptoms and migraine outcomes are not understood. In a clinical cohort of youth diagnosed with migraine, this longitudinal study aimed to examine: (1) the daily associations between same-day anxiety and mood symptom burden, same-day state pain catastrophizing, and migraine-related disability; and (2) the association between anxiety and mood symptom burden in the 24 and 48-hour period prior a migraine attack and migraine-related disability on the attack day.
Methods
Participants included fifty-five children and adolescents (Mage = 13.82, SDage = 2.80, range = 8-17, 84% girls) diagnosed with migraine. At baseline, participants provided sociodemographic information and completed a self-reported measure of migraine-related disability. Subsequently, participants completed daily diary measures over 30 days, including assessments of migraine severity, migraine-related disability, and day-to-day state anxiety, mood, and pain catastrophizing. Multilevel linear regression models were used to describe the association between same-day migraine-related disability and independent variables including same-day anxiety, mood symptom burden, and state pain catastrophizing (Model 1), as well as anxiety and mood symptom burden assessed in the 24 and 48 hours preceding the migraine attack (Model 2). Covariates included participants’ age, sex, baseline migraine-related disability scscores, and same-day pain severity. Random intercepts and random slopes were included.
Results
In Model 1, higher migraine-related disability was associated with lower same day mood levels (B = -0.12, SE = 0.04, t = -3.08, P = .004) and higher same day anxiety (B = 0.07, SE = 0.03, t = 2.17, P = .035) and state pain catastrophizing levels (B = 0.03, SE = 0.01, t = 2.36, P = .007), after controlling for sex, age, baseline migraine-related disability, and same-day pain severity. In Model 2, no significant associations were found between daily migraine-related disability and mood and anxiety symptom levels in the 24 and 48-hour period preceding attack onset. Pain severity was significantly associated with migraine-related disability in both models, with higher pain severity levels associated with higher disability (Model 1: B = 0.20, SE = 0.03, t = 7.37, P < .001; Model 2: B = 0.26, SE = 0.03, t = 10.29, P < .001).
Conclusions
Same-day migraine-related disability appeared to be associated with lower same day mood, and higher same-day anxiety and pain catastrophizing. Conversely, anxiety and mood burden in the 24 and 48 hours prior to the attack were not associated with migraine-related disability on attack days in our cohort. Thus, while mental health symptoms were elevated on attack days with high disability, preceding mental health symptoms did not predict upcoming disability levels. Our results challenge hypotheses that mental health symptoms may reliably predict subsequent migraine-related disability in youth on a short-term basis and underscore the need to further study these relationships.
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Presenting Author
Josep Roman-Juan
Poster Authors
Josep Roman-Juan
MSc
Universitat Rovira i Virgili. Catalonia, Spain
Lead Author
Kirsten Sjonnesen
MD
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta,Canada
Lead Author
Ashley D. Harris
PhD
Department of Radiology, University of Calgary, Calgary, Alberta, Canada
Lead Author
Jonathan Kuziek
MSc
Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta,Canada
Lead Author
Lindsay Craddock
NP
Department of Nursing, University of Calgary, Calgary, Alberta, Canada
Lead Author
Vineeha Warriyar.K.V.
PhD
Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
Lead Author
Melanie N. Noel
PhD
Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
Lead Author
Serena L. Orr
MD
Alberta Children’s Hospital Research Institute, Calgary, Alberta, Canada
Lead Author
Topics
- Mechanisms: Psychosocial and Biopsychosocial