abuse in chronic migraine patients exists as compared to such a history in episodic migraine patients .
Medical records for new patients at a headache clinic during a 4-month period were reviewed . All new patients with a diagnosis of migraine or chronic migraine were included in the study . A total of 194 patients with a diagnosis of chronic migraine ( defined by International Headache Society criteria as having ≥ 15 headache days per month for > 3 months ) were included , while 135 patients with a diagnosis of episodic migraine were included .
Of the 329 patients included in this study , 10.9 % reported a history of sexual abuse across both chronic and episodic migraine . Six episodic migraineurs ( 4.4 %) endorsed a history of sexual abuse , whereas 30 patients with chronic migraine ( 15.5 %) indicated a previous history of sexual abuse . Patients with chronic migraine were 3 ½ times more likely than episodic migraine patients to report a history of sexual abuse .
As this study was conducted at a headache clinic , it would be expected to include more chronic migraine patients ; in fact , there were 44 % more patients with chronic migraine than episodic migraine . It is likely that under-reporting of a sexual abuse history occurred in both patient groups , especially since the history was obtained during the initial office visit . Under-reporting is also considered to be very likely when these results are compared with national statistics regarding sexual abuse . The Centers for Disease Control estimated in 2014 , that 1 in 4 girls and 1 in 6 boys are sexually abused before the age of 18 , and that 18 % of women in the United States have been victims of rape .
These findings suggest that a history of sexual abuse may be an important factor in the transformation of episodic migraine to chronic migraine . Anxiety and depression , which are common in victims of abuse , are factors which are also associated with increased transformation to chronic migraine . Whether a history of sexual abuse has a direct causal relationship in this transformation is unclear ; perhaps such a history worsens anxiety or depression which may , in turn , impact transformation to chronic migraine .
20 HeadWise ® | Volume 6 , Issue 1 • 2016