I didn't expect such numbers: Found a high prevalence of rape (13.06%) in women having chronic migrane, and 30% of refractory migraine

High Prevalence of Rape and Sexual Abuse among Chronic and Refractory Migraine Patients (P3.10-010). Agustin Oterino Duran, Maria Toriello, Fernando Iglesias, Fernando Hoyuela, Sara Perez-Pereda, Vicente Gonzalez-Quintanilla, Olga Umaran, Javier-Gonzalo Ocejo. Neurology, April 09, 2019; 92 (15 Supplement) May 7, 2019. https://n.neurology.org/content/92/15_Supplement/P3.10-010

Abstract

Objective: To analyze the prevalence of early adverse experiences and post-traumatic stress disorder (PTSD) among migraine patients in an outpatient migraine-dedicated clinic.

Background: PTSD has a prevalence of 22% among migraineurs, hardly increasing the risk for higher disability. Adverse childhood experiences (ACE) have been associated with migraine and had a strong correlation with migraine severity.

Design/Methods: We prospectively analyzed the prevalence of PTSD in a hospital-based migraine-dedicated outpatient clinic. We randomly selected 64 subjects among aproximately 1000 subjects attended a year. Self-administered MIDAS, Beck Anxiety (BAI), and Depression (BDI) inventories, Fatigue Scale (FS), and Traumatic Questionaire (TQ) were obtained from all patients. Chi2, t-test, and non-parametric tests were used.

Results: After informed consent, a total of 64 patients 46 CM (10 had refractory migraine [RM[) mean of age 45.00±8.5y) and 18 frequent, episodic migraine (39.17±11.7y; p=0.036). MIDAS was higher in CM (91.65±77.0) than EM (50.7±29.9; p=0.032) and higher number of headache days (CM=61.65±23.7; EM=36.75±20.9; p=0.014). BDI, BAI, and FS showed no differences among EM, CM nor RM. TQ was positively answered in 13/18 EM, and in 31/46 CM (n.s.). A total of 5 subjects recognized having been raped (3 RM, 2 CM); 2 suffered incest. Physical abuse was recognized in 11 patients (6 CM, 3 RM, and 2 EM); 8 suffered severe aggression (6MC, 1RM, 1EM);16 recognized mobbing, bulling, or psychological misconduct (14 MC, 1 RM, 1 EM). We found no differences in SF-12 both physical (EM=36.68±9.7; CM=35.4±8.9) and mental dimensions (EM=42.36±11.3; CM=40.17±11.2). SF-12 components inversely correlated with PTSD, BDI, BAI, and FSS scores (for all p<0.01).

Conclusions: We found a high prevalence of rape (13.06%) in women having CM, and 30% of RM. PTSD was associated with more disabling migraine.

We suggest that antecedents of sexual abuse, physical abuse, and violation could be routinally addressed in chronic migraine to undergo specific psychological therapies.