A Retrospective, Comparative Study on the Frequency of Abuse in Migraine and Chronic Daily Headache

B. Lee Peterlin, DO; Thomas Ward, MD; Jeffrey Lidicker, MSc; Morris Levin, MD


Headache. 2007;47(3):397-401. 

In This Article

Materials and Methods

This is a retrospective study, conducted from December 2004 to August 2005 at an out-patient headache clinic. The charts of 183 new headache patients from our facility were retrospectively reviewed.

During the entire duration of the study, all patients seen in the clinic were interviewed, examined, and diagnosed by one of us (BLP) and reviewed with one of the co-authors (TNW or ML). Information was then abstracted from the charts into semi-standardized forms developed for this study.

Subjects were classified according to the Second Edition of the International Classification of Headache Disorders (ICHD-2). According to their diagnosis, patients were divided into 2 groups. Group 1 consisted of CDH patients having an ICHD-2 code of probable medication overuse headaches (MOH) or chronic migraine (CM) and group 2 consisted of migraineurs with an ICHD-2 code of migraine with (MWA) or without aura (MWoA).[8]

Charts were then reviewed for a patient self-reported history of physical and/or sexual abuse at any time in their life. Patients were simply and systematically asked "Do you have any history of physical abuse at any time in your life?" and "Do you have any history of sexual abuse at any time in your life?" following the intake of their past medical history. No definitions of physical or sexual abuse were provided. No attempt was made to verify the patient's report of abuse or at what age the abuse began or ended.

Fisher exact test was used for comparisons of categorical, demographic variables. A 2-tailed T-test was used for comparison of continuous demographic variables. As a preliminary study has shown that abuse was more prevalent in CDH than in migraine,[7] hypothesis tests associating CDH and migraine frequencies to abuse are assumed to be one-sided. Data was summarized using summary tables. Proportions were compared using a standard 1-sided 2-sample proportions test. The study was IRB approved.


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