Portal de Periódicos da CAPES

(882)

2006; Elsevier BV; Volume: 7; Issue: 4 Linguagem: Inglês

10.1016/j.jpain.2006.01.284

1528-8447

Kenneth J. Holroyd, Constance Cottrell, Jana Brittain Drew,

Migraine and Headache Studies

We examined the impact of migraine characteristics, affective variables, and catastrophizing on impairments in functioning and quality-of-life (Fn/QoL) in frequent migraine sufferers. Predictor variables, including demographic characteristics, migraine characteristics (migraine days, pain severity, and migraine associated symptom severity), mood and anxiety disorders (PrimeMD diagnosis), symptoms of anxiety (Beck Anxiety Scale; BAI) and depression (Beck Depression Scale II) and a modified Pain Catastrophizing Scale (PCS) were assessed at Time 1 in 229 frequent migraine sufferers (81% female; mean age= 38; 83% Caucasian; mean migraine/days mo. = 8.5). Participants also recorded migraine characteristics (migraine episodes and associated symptoms) and migraine-related impairment for 5 weeks using electronic (Palm OS) diaries. Major self-report Fn/QoL measures were assessed 5 weeks later at Time 2. Fn/QoL measures included Migraine Specific Quality of Life scale (MSQL), Headache Disability scale (HDI), Medical Outcomes Study Short Form (MOS-SF36), Migraine Disability Assessment questionnaire (MIDAS), and Palm Diary recordings of disability and impaired functioning (work, social recreational, lost sleep) hours. Backward regression (p< .10 to remove) revealed that determinants of Fn/QoL varied across different Fn/QoL measures, with comprehensive Fn/QoL measures (MSQL, HDI) that also assess migraine-related affective distress and restriction of activity in anticipation of a migraine, sensitive to a greater number of predictor variables than measures assessing only impaired performance (MIDAS, Diary). However, catastrophizing assessed at Time 1 was a robust independent predictor (p< .001) of impairment on each of the 5 Fn/ QoL measures at Time 2. This is the first demonstration that a catastrophizing response migraines predicts impaired Fn/QoL independent of migraine characteristics and other psychological and demographic variables. This suggests that improvements in Fn/QoL can be improved if treatment targets include not only migraine pain, but also catastrophizing in anticipation of, and in response to, migraine.