Are depressive symptomatology, self-efficacy, and perceived social support related to disability and quality of life in patients with chronic migraine associated to medication overuse? Data from a cross-sectional study.
BACKGROUND
Chronic migraine with medication overuse (CM-MO) impairs quality of life (QoL) and causes disability. Psychosocial variables such as depressive symptomatology, self-efficacy, and social support have been sparingly investigated, and their impact on disability and QoL is unknown.


METHODS
Patients with CM-MO under withdrawal were consecutively enrolled. Standardized measures of disability and QoL were used as outcomes; psychosocial (ie, mood state, self-efficacy, social support) and clinical (ie, headache frequency and intensity) variables were considered as associated variables. Associations between these variables, disability, and QoL were tested with Pearson's correlations. Hierarchical multiple regression was used to assess the cumulative contribution of psychosocial variables on disability and QoL variation when added to clinical variables.


RESULTS
One hundred ninety-four patients were enrolled; 82.5% were females and mean age was 43.9. Disability and QoL were moderately or little correlated to clinical and psychosocial variables. Models based on clinical variables explained 7.5-14.3% of disability and QoL variation, with pain intensity being the only significant predictor; when psychosocial variables were added, the explained variation increased to 21.5-35.2%, with depressive symptomatology always having independent predictive power and perceived social support having independent predictive power in the regression model over role-prevention component of QoL.


CONCLUSIONS
Adding information on psychosocial variables to headache features improved our ability to understand disability and QoL of CM-MO patients. We deem that the inclusion of psychosocial variables in standard evaluation protocols may contribute to the global assessment of CM-MO patients, and eventually to their success in reducing the personal and social impact of this condition. Future longitudinal studies are needed to confirm this hypothesis.
Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Domenico
D
D'Amico
Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Licia
L
Grazzi
Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Gennaro
G
Bussone
Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Marcella
M
Curone
Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Paola
P
Di Fiore
Headache and Neuroalgology Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Susanna
S
Usai
Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Matilde
M
Leonardi
Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Ambra Mara
AM
Giovannetti
Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Silvia
S
Schiavolin
Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
Alberto
A
Raggi
D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D010465:Perception; D000067490:Prescription Drug Overuse / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support
chronic migraine with medication overuse; disability evaluation; health-related quality of life; mood; self-efficacy; social support