Perceived stress in patients with migraine: a case-control study

Abstract

Background: Perceived stress is the most common trigger for migraine. The objective of this study was to examine the clinical significance of perceived stress in migraine patients. Methods: This is a case-control study. Consecutive migraine patients who visited a tertiary care hospital were enrolled for this study. They completed self-reported questionnaires including Perceived Stress Scale (PSS), 12-item Allodynia Symptom Checklist (ASC-12), Migraine Disability Assessment Scale (MIDAS), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and Migraine-Specific Quality of Life Questionnaire (MSQ). Degree of perceived stress in migraine patients was measured and compared to that in healthy controls. Predictors for perceived stress and their impact on quality of life (QOL) of migraine patients were also determined. Results: A total of 227 migraine patients were eligible for this study, including 103 (45.4%) who had chronic migraine (CM). Mean PSS score was significantly (p < 0.05) higher in CM patients than that in controls after adjusting for education, depression, and anxiety. Although several factors were associated with PSS score, major predictors for PSS were GAD-7 score (beta = 0.358, p < 0.001), PHQ-9 score (beta = 0.304, p < 0.001), ISI score (beta = 0.154, p = 0.005), and CM (beta = -0.104, p = 0.027). There was an inverse relationship between PSS scores and three-dimensional scores of MSQ (p < 0.001). Conclusions: Chronic migraine is a critical factor for perceived stress. Perceived stress affects QOL of migraine patients.