The association of migraine with menstrually related mood disorders and childhood sexual abuse.
BACKGROUND
Both female reproductive hormones and childhood sexual abuse (CSA) are implicated in migraine and in menstrually related mood disorders (MRMD). We examined the association of migraine, including migraine with aura (MA), and history of MRMD or CSA.


METHODS
A total of 174 women (mean age 33.9 ± 7.6 years) in this cross-sectional study were evaluated for (1) current MRMD using prospective daily ratings; (2) history of CSA using structured interview; and (3) MA and migraine without aura using the International Classification of Headaches Disorders II criteria.


RESULTS
Ninety-six women met MRMD criteria (21 of whom had history of CSA) and 78 women were non-MRMD controls (16 with CSA histories). Migraine with aura was more prevalent in women with MRMD when compared to non-MRMD controls (11/88 and 0/86, respectively, p=0.001). In MRMD women only, a CSA history was associated with higher MA rates (6/21 and 5/67, respectively, p=0.019). A combination of current MRMD diagnosis and a history CSA was associated with increased risk for MA, even after adjusting for potential confounders (odds ratio=12.08, 95% confidence interval 2.98-48.90, p<0.001).


CONCLUSIONS
Women with MRMD may be vulnerable to the development of MA, and a history of CSA in women with a MRMD appears to increase that vulnerability. MRMDs and MA should be included among other poor mental and physical health outcomes of an abuse history. Routine screening for abuse histories would potentially improve identification of women with increased risk of experiencing abuse-related disorders.
Department of Psychiatry, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
Adomas
A
Bunevicius
David R
DR
Rubinow
Anne
A
Calhoun
Jane
J
Leserman
Erin
E
Richardson
Kim
K
Rozanski
Susan S
SS
Girdler
D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000704:Analysis of Variance; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D019964:Mood Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D055815:Young Adult