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

Disclosures

Headache. 2007;47(3):397-401. 

In This Article

Results

Of the 183 patients, 22 patients were excluded; 21 of these patients had headache diagnoses other than those pertaining to the study. One was eliminated due to lack of information on abuse.

Of the 161 patients included in the study, 145 (90.1%) were female and 16 (9.9%) were male. The mean age was 36.4 SD ±12.0. Information on race was unavailable on 2 charts; marital status was unavailable from 3 charts; and information on a history of a previous marriage was unavailable on 8 charts. Overall, 156 (98.1%) of 159 patients were Caucasian. Of the 158 patients whose marital status was available, 83 (52.5%) were married and 75 (47.5%) were single. Overall, 30 (19.6%) of 153 patients had a history of a previous marriage ( Table 1 ).

A total of 95 (59.0%) patients were diagnosed with CDH (either MOH or CM) and 66 (41.0%) patients were diagnosed with migraine or probable migraine with and/or without aura. Among the 95 patients with CDH, 72 (75.8%) were diagnosed with probable MOH and 23 (24.2%) had CM; and among the 66 migraineurs, 42 (63.6%) had only migraine without aura and 24 (36.4%) had MWA with or without MWoA.

Overall, 34.8 ± 3.8% of all patient's included in this study reported a history of physical and/or sexual abuse ( Table 1 ). A total of 14.9 ± 2.8% reported a history of both physical and sexual abuse, 26.7 ± 3.5% reported sexual abuse (either isolated or in association with physical abuse), and 23.0 ± 3.3% reported physical abuse (either in isolation or in association with sexual abuse). Sexual abuse alone was reported by 11.8 ± 2.5% and physical abuse alone was reported by 8.1 ± 2.1%.

In the CDH group, 40.0 ± 5.0% reported physical and/or sexual abuse. A total of 16.8 ± 3.8% reported a history of both physical and sexual abuse, 30.5 ± 4.7% reported a history of sexual abuse (either isolated or in association with physical abuse), and 26.3 ± 4.5% reported a history of physical abuse (either isolated or in association with sexual abuse). Sexual abuse alone was reported by 13.7 ± 3.5% and physical abuse alone was reported by 9.4 ± 3.0% in the CDH group.

Of patients with migraine, 27.3 ± 5.5% reported physical and/or sexual abuse. A total of 12.1 ± 4.0% reported a history of both physical and sexual abuse; 21.2 ± 5.0% reported a history of sexual abuse (either isolated or in association with physical abuse), and 18.2 ± 4.7% reported a history of physical abuse (either isolated or in association with sexual abuse). Sexual abuse alone was reported by 9.1 ± 3.5% and physical abuse alone was reported by 6.1 ± 2.9% in the migraine group (Fig. 1).

Percent of overall, CDH, and migraine patients reporting abuse histories. The relative frequency of physical and/or sexual abuse is significantly higher in CDH patients as compared to migraineurs (P = .048).

Contrasting the relative frequency of abuse in the CDH group to the migraine group showed a significant difference between patients reporting physical and/or sexual abuse (P = .048). There was no significant difference for any other subgroup including both physical and sexual abuse (P = .20), sexual abuse, (isolated or in association with physical abuse, P = .094), physical abuse (isolated or in association with physical abuse, P = .11), sexual abuse alone (P = .19), or physical abuse alone (P = .22).

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