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Clinical Pain Catastrophizing in Women With Migraine and Obesity
Author(s) -
Bond Dale S.,
Buse Dawn C.,
Lipton Richard B.,
Thomas J. Graham,
Rathier Lucille,
Roth Julie,
Pavlovic Jelena M.,
Evans E. Whitney,
Wing Rena R.
Publication year - 2015
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12597
Subject(s) - pain catastrophizing , migraine , medicine , anxiety , physical therapy , depression (economics) , hospital anxiety and depression scale , psychiatry , chronic pain , economics , macroeconomics
Objective/Background Obesity is related to migraine. Maladaptive pain coping strategies (eg, pain catastrophizing) may provide insight into this relationship. In women with migraine and obesity, we cross‐sectionally assessed: (1) prevalence of clinical catastrophizing; (2) characteristics of those with and without clinical catastrophizing; and (3) associations of catastrophizing with headache features. Methods Obese women migraineurs seeking weight loss treatment (n = 105) recorded daily migraine activity for 1 month via smartphone and completed the P ain C atastrophizing S cale ( PCS ). Clinical catastrophizing was defined as total PCS score ≥30. The six‐item H eadache I mpact T est ( HIT ‐6), 12‐item A llodynia S ymptom C hecklist ( ASC ‐12), H eadache M anagement S elf‐ E fficacy S cale ( HMSE ), and assessments for depression ( C enters for E pidemiologic S tudies D epression S cale) and anxiety (seven‐item G eneralized A nxiety D isorder S cale) were also administered. Using PCS scores and body mass index ( BMI ) as predictors in linear regression, we modeled a series of headache features (ie, headache days, HIT ‐6, etc) as outcomes.Results One quarter (25.7%; 95% confidence interval [ CI ] = 17.2‐34.1%) of participants met criteria for clinical catastrophizing: they had higher BMI (37.9 ± 7.5 vs 34.4 ± 5.7 kg/m 2 , P = .035); longer migraine attack duration (160.8 ± 145.0 vs 97.5 ± 75.2 hours/month, P = .038); higher HIT ‐6 scores (68.7 ± 4.6 vs 64.5 ± 3.9, P < .001); more allodynia (7.0 ± 4.1 vs 4.5 ± 3.5, P < .003), depression (25.4 ± 12.4 vs 13.3 ± 9.2, P < .001), and anxiety (11.0 ± 5.2 vs 5.6 ± 4.1, P < .001); and lower self‐efficacy (80.1 ± 25.6 vs 104.7 ± 18.9, P < .001) compared with participants without clinical catastrophizing. The odds of chronic migraine were nearly fourfold greater in those with (n = 8/29.6%) vs without (n = 8/10.3%) clinical catastrophizing (odds ratio = 3.68; 95% CI = 1.22‐11.10, P = .021). In all participants, higher PCS scores were related to more migraine days (β = 0.331, P = .001), longer attack duration (β = 0.390, P < .001), higher HIT ‐6 scores (β = 0.425, P < .001), and lower HMSE scores (β = −0.437, P < .001). Higher BMI , but not higher PCS scores, was related to more frequent attacks (β = −0.203, P = .044). Conclusions One quarter of participants with migraine and obesity reported clinical catastrophizing. These individuals had more frequent attacks/chronicity, longer attack duration, higher pain sensitivity, greater headache impact, and lower headache management self‐efficacy. In all participants, PCS scores were related to several migraine characteristics, above and beyond the effects of obesity. Prospective studies are needed to determine sequence and mechanisms of relationships between catastrophizing, obesity, and migraine.