A history of childhood sexual abuse is nearly fourfold more common among patients with chronic migraine than in those with episodic migraine, according to research presented at the International Headache Congress. This association raises the possibility that prior sexual abuse is a contributing factor in the transformation from episodic migraine to chronic migraine, said Brad Torphy, MD, of Diamond Headache Clinic in Chicago.
Based upon his experience in the clinic, Dr. Torphy suspects that the true proportion of patients with a positive history for sexual abuse is considerably higher than the rates the new-patient questionnaire would suggest.
“A lot of factors would lead to that being a very low number,” Dr. Torphy said. “It’s the patient’s first visit, and and it’s a paper questionnaire, so patients may not be comfortable checking that box when they don’t know who’s going to see the results. I’ve had cases where patients shared with me only after two or three visits that, yes, I do have that history. I think it’s underreported across the board.”
“The clinical implications of these findings, and what I’m stressing, is the importance of intervention – such as psychological counseling – in episodic migraine patients who have had a history of abuse.”
In his review of the literature, he found that other investigators have tended to either lump together all kinds of abuse – physical, emotional, and sexual – in analyzing an association with migraine, or if they looked at sexual abuse in particular, it was in association with all types of chronic pain, not specifically migraine.
October, 2015