title: Predictors of disability in migraineurs referred to a tertiary clinic: neck pain, headache characteristics, and coping behaviors.
abstract: OBJECTIVE
  The aim of this retrospective study was to determine if neck pain, select headache characteristics, and migraine-related coping response predicted disability in migraineurs referred to a tertiary headache clinic.
  
  
  METHODS
  Patients seeking treatment at a neurology-based headache clinic were included if they met diagnostic criteria for migraine with or without aura according to the International Headache Society (1.1, 1.2). Subjects completed a self-report headache history form and a detailed headache and neurologic examination. The headache history form assessed: 1)weekly headache frequency; 2) number of weekly severe headaches; 3) presence of migraine-related neck pain; 4) photophobia; 5) phonophobia; 6) headache duration; 7) vomiting; 8) monthly headache-free days; and 9) behavioral coping style. Disability was assessed using a self-report inventory (HIT-6).
  
  
  RESULTS
  Self-reported headache severity, frequency, and headache-free days were strongly associated with disability. The presence of neck pain during migraine and one's coping response to migraine significantly predicted disability independent of headache characteristics.
  
  
  CONCLUSIONS
  These data suggest the need for prospective research exploring the causal mechanisms by which neck pain and coping response influence disability and underscores the importance of multidisciplinary approaches to headache management.
authors: Department of Neurology, University of North Carolina, Chapel Hill, NC 27599, USA.
authors: Sutapa
authors: S
authors: Ford
authors: Anne
authors: A
authors: Calhoun
authors: Kevin
authors: K
authors: Kahn
authors: John
authors: J
authors: Mann
authors: Alan
authors: A
authors: Finkel
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology*; D009325:Nausea / Q000209:etiology; D019547:Neck Pain / Q000209:etiology*; D018710:Pain Clinics; D020795:Photophobia / Q000209:etiology; D012189:Retrospective Studies