title: The role of headache chronicity among predictors contributing to quality of life in patients with migraine: a hospital-based study.
abstract: BACKGROUND
  Headache chronicity has been known to elicit deleterious effects on quality of life (QOL). We evaluated the contribution of headache chronicity to QOL in relation to clinical, psychiatric, and psychosocial variables in patients with migraine.
  
  
  METHODS
  Subjects were recruited from a headache clinic and completed self-report questionnaires including the Migraine Disability Assessment (MIDAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Migraine-Specific Quality of Life (MSQoL). We obtained predictors of MSQoL by multiple regression analyses. A path analysis model was constructed to analyze interrelationships between the variables.
  
  
  RESULTS
  Among 251 eligible patients, 183 (72.9%) had episodic migraine (EM) and 68 (27.1%) had chronic migraine (CM). Patients with CM had more serious clinical, psychiatric, and poor QOL than did patients with EM. The strongest predictor of the MSQoL score in all patients with migraine was the BDI score (β = -0.373, p < 0.001), followed by the MIDAS score (β = -0.223, p < 0.001), female gender (β = -0.192, p < 0.001), attack duration (β = -0.159, p = 0.001), and headache chronicity (β = -0.130, p = 0.012). Headache chronicity had a direct effect on the MSQoL score and exerted an indirect effect on the MSQoL score through the MIDAS and the BDI scores.
  
  
  CONCLUSIONS
  Chronic migraine appears to impair QOL directly as well as indirectly by provoking disability and depression.
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Neurology, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 700-842, Republic of Korea. sppark@mail.knu.ac.kr.
authors.forename: Sung-Pa
authors.initials: SP
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000503:physiopathology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D013997:Time Factors; D055815:Young Adult