Hostname: page-component-5d84bcc8dc-jpx87 Total loading time: 0 Render date: 2026-09-14T20:28:15.797Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental pain and pain-proneness in patients with migraine: results from the PAINMIG cohort-study

Published online by Cambridge University Press:  25 June 2020

Fiammetta Cosci Open the ORCID record for Fiammetta Cosci [Opens in a new window] ,
Andrea Svicher ,
Giovanni Mansueto ,
Silvia Benemei ,
Alberto Chiarugi ,
Francesco De Cesaris ,
Jenny Guidi Open the ORCID record for Jenny Guidi [Opens in a new window]  and
Stephan Zipfel
Fiammetta Cosci*
Affiliation:
Department of Health Science, University of Florence, Florence, Italy Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
Andrea Svicher
Affiliation:
Department of Health Science, University of Florence, Florence, Italy
Giovanni Mansueto
Affiliation:
Department of Health Science, University of Florence, Florence, Italy
Silvia Benemei
Affiliation:
Headache and Clinical Pharmacology Center, Careggi University Hospital, Florence, Italy
Alberto Chiarugi
Affiliation:
Department of Health Science, University of Florence, Florence, Italy Headache and Clinical Pharmacology Center, Careggi University Hospital, Florence, Italy
Francesco De Cesaris
Affiliation:
Headache and Clinical Pharmacology Center, Careggi University Hospital, Florence, Italy
Jenny Guidi
Affiliation:
Department of Psychology, University of Bologna, Bologna, Italy
Stephan Zipfel
Affiliation:
Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany
*
Author for correspondence: Fiammetta Cosci, MD, MSc, PhD Email: fiammetta.cosci@unifi.it
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Pain has been qualified under four categories: nociception, perception of pain, suffering, and pain behaviors. Most of the literature on migraine has devoted attention to the first two. The aim of the present cohort study was to investigate patients with migraine enrolled at a tertiary care unit to study suffering and mental pain and identify potential risk factors for migraine.

Methods

An observational cross-sectional study was carried out on patients with chronic migraine (CM) and episodic migraine (EM), and healthy subjects (HS). The three groups were matched for age and sex. A comprehensive assessment of migraine disability, pain, psychiatric disorders, psychosomatic syndromes, depressive and anxious symptoms, euthymia, psychosocial variables, mental pain, and pain-proneness (PP) was performed.

Results

Three hundred subjects were enrolled (100 CM, 100 EM, and 100 HS). Based on the multiple regression analyses, those presenting PP (social impairment: odds ratio [OR] = 3.59, 95% confidence interval [CI] = 1.14-11.29; depressive symptoms: OR = 3.82, 95% CI = 1.74-8.41) were more likely to be CM than HS. Those with higher levels of PP (social impairment: OR = 4.04, 95% CI = 1.60-10.22; depressive symptoms: OR = 2.02, 95% CI = 1.26-3.24) were more likely to be EM than HS. Those presenting higher levels of mental pain were more likely to be CM than EM (OR = 1.45, 95% CI = 1.02-2.07).

Conclusion

Migraine is an unpleasant sensory and emotional experience associated with psychosocial manifestations that might contribute to the level of suffering of the individuals. Mental pain resulted to be the variable that most differentiated patients with CM from EM.

Keywords

Mental painpain-pronenessDCPRmigrainepsychological distress

Information

Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 5 , October 2021 , pp. 491 - 500
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Charles, A. The pathophysiology of migraine: implications for clinical management. Lancet Neurol. 2018;17(2):174–182.10.1016/S1474-4422(17)30435-0CrossRefGoogle ScholarPubMed
Schulte, LH, May, A. Of generators, networks and migraine attacks. Curr Opin Neurol. 2017;30(3):241–245.10.1097/WCO.0000000000000441CrossRefGoogle ScholarPubMed
Russo, A, Coppola, G, Pierelli, F, et al. Pain perception and migraine. Front Neurol. 2018;9:576.10.3389/fneur.2018.00576CrossRefGoogle ScholarPubMed
Hooten, MW. Chronic pain and mental health disorders: shared neural mechanisms, epidemiology, and treatment. Mayo Clin Proc. 2016;91(7):955–970.10.1016/j.mayocp.2016.04.029CrossRefGoogle Scholar
Borsook, D, Youssef, AM, Barakat, N, et al. Subliminal (latent) processing of pain and its evolution to conscious awareness. Neurosci Biobehav Rev. 2018;88:1–15.10.1016/j.neubiorev.2018.02.015CrossRefGoogle ScholarPubMed
Fava, GA, Tomba, E, Brakemeier, EL, et al. Mental pain as a transdiagnostic patient-reported outcome measure. Psyhcother Psychosom. 2019;88(6):341–349.10.1159/000504024CrossRefGoogle ScholarPubMed
Loeser, JD, Melzack, R. Pain: an overview. Lancet. 1999;353:1607–1609.10.1016/S0140-6736(99)01311-2CrossRefGoogle ScholarPubMed
Loeser, JD. Pain and suffering. Clin J Pain. 2000;16:S2–S6.10.1097/00002508-200006001-00002CrossRefGoogle ScholarPubMed
Sensky, T. Suffering, Int J Integr Care. 2010;10:66–68.10.5334/ijic.494CrossRefGoogle ScholarPubMed
Saunders, C. The treatment of intractable pain in terminal cancer. Proc Royal Soc Med. 1963;56:195–197.10.1177/003591576305600322CrossRefGoogle ScholarPubMed
Saunders, C. Distress in dying. BMJ. 1963;2:746.10.1136/bmj.2.5359.746-aCrossRefGoogle Scholar
Frankl, VE. Men’s Search for Meaning. New York, NY: First Washington Square Press; 1963.Google Scholar
Bakan, D. Disease, Pain, and Sacrifice: Toward a Psychology of Suffering. Chicago, IL: Beacon; 1971.Google Scholar
Baumeister, RF. Suicide as escape from self. Psychol Rev. 1968;97(1):90–113.10.1037/0033-295X.97.1.90CrossRefGoogle Scholar
Shneidman, ES. Commentary: suicide as psychache. J Nerv Ment Dis. 1993;181(3):145–147.10.1097/00005053-199303000-00001CrossRefGoogle Scholar
Shneidman, ES. The Suicidal Mind. New York, NY: Oxford University Press; 1996.Google Scholar
Bolger, EA. Grounded theory analysis of emotional pain. Psychother Res. 1999;9(3):342–362.10.1093/ptr/9.3.342CrossRefGoogle Scholar
Orbach, I, Mikulincer, M, Sirota, P, et al. Mental pain: a multidimensional operationalization and definition. Suicide Life Threat Behav. 2003;33(3):219–230.10.1521/suli.33.3.219.23219CrossRefGoogle ScholarPubMed
Fava, GA. Well-being therapy: current indications and emerging perspectives. Psychother Psychosom. 2016;85(3):136–145.10.1159/000444114CrossRefGoogle ScholarPubMed
Fava, GA. Well-Being Therapy: Treatment Manual and Clinical Applications. Basel, Switzerland: Karger; 2016.10.1159/isbn.978-3-318-05822-2CrossRefGoogle Scholar
Orbach, I, Palgi, Y, Stein, D, et al. Tolerance of physical pain in suicidal individuals. In: Death Stud. Vol. 20; 1996:327–341.10.1080/07481189608252786CrossRefGoogle Scholar
Orbach, I, Stein, D, Palgi, Y, et al. Perception of physical pain in accident and suicide attempt patients: self preservation vs self-destruction. J Psychiatr Res. 1996;30:307–320.10.1016/0022-3956(96)00008-8CrossRefGoogle ScholarPubMed
Orbach, I, Mikulincer, M, Cohen, D, et al. Thresholds and tolerance of physical pain in suicidal and nonsuicidal adolescents. J Consult Clin Psychol. 1997;65:646–652.10.1037/0022-006X.65.4.646CrossRefGoogle ScholarPubMed
Engel, G. “Psychogenic” pain and the pain-prone patient. Am J Medicine. 1959;26:899–918.10.1016/0002-9343(59)90212-8CrossRefGoogle ScholarPubMed
Blumer, D, Heilbronn, M. Chronic pain as a variant of depressive disease. The pain prone disorder. J Nerv mental Dis. 1982;170(7):381–406.10.1097/00005053-198207000-00001CrossRefGoogle ScholarPubMed
Ziegler, DK, Paolo, AM. Headache symptoms and psychological profile of headache-prone individuals. A comparison of clinic patients and controls. Arch Neurol. 1995;52(6):602–606.10.1001/archneur.1995.00540300076016CrossRefGoogle ScholarPubMed
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808.10.1177/0333102413485658CrossRefGoogle Scholar
Rubin, DB. Matching to remove bias in observational studies. Biometrics. 1973;29:159–184.10.2307/2529684CrossRefGoogle Scholar
Cosci, F, Fava, GA. New clinical strategies of assessment of comorbidity associated with substance use disorders. Clin Psychol Rev. 2011;31(3):418–427.10.1016/j.cpr.2010.11.004CrossRefGoogle ScholarPubMed
Cosci, F, Abrams, K, Schruers, KR, et al. Effect of nicotine on 35% CO2-induced anxiety: a study in healthy volunteers. Nicotine Tob Res. 2006;8(4):511–517.10.1080/14622200600789643CrossRefGoogle ScholarPubMed
Stewart, WF, Lipton, RB, Dowson, AJ, et al. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology. 2001;56(suppl 1):S20–S28.CrossRefGoogle ScholarPubMed
Caraceni, A, Mendoza, TR, Mencaglia, E, et al. A validation study of an Italian version of the Brief Pain Inventory (Breve Questionario per la Valutazione del Dolore). Pain. 1996;65(1):87–92.10.1016/0304-3959(95)00156-5CrossRefGoogle Scholar
First, MB, Williams, JBW, Karg, RS, et al. Structured Clinical Interview for DSM-5 Disorders, Clinician Version (SCID-5-CV). Arlington, VA: American Psychiatric Association; 2016.Google Scholar
Cosci, F, Svicher, A, Romanazzo, S, et al. Criterion-related validity in a sample of migraine outpatients: the Diagnostic Criteria for Psychosomatic Research. CNS Spectr. 2019;1–7.Google Scholar
Guidi, J, Fava, GA, Bech, P, et al. The Clinical Interview for Depression: a comprehensive review of studies and clinimetric properties. Psychother Psychosom. 2011;80:10–27.10.1159/000317532CrossRefGoogle ScholarPubMed
Fava, GA, Bech, P. The concept of euthymia. Psychother Psychosom. 2016;85:1–5.10.1159/000441244CrossRefGoogle ScholarPubMed
Piolanti, A, Offidani, E, Guidi, J, et al. Use of the Psychosocial Index: a sensitive tool in research and practice. Psychother Psychosom. 2016;85(6):337–345.10.1159/000447760CrossRefGoogle ScholarPubMed
Glasofer, DR, Brown, AJ, Riegel, M. Structured Clinical Interview for DSM-IV (SCID). In: Wade, T, ed. Encyclopedia of Feeding and Eating Disorders. Singapore: Springer; 2015:1–4.Google Scholar
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62.10.1136/jnnp.23.1.56CrossRefGoogle ScholarPubMed
Carrozzino, D, Svicher, A, Patierno, C, et al. The Euthymia Scale: a clinimetric analysis. Psychother Psychosom. 2019;88(2):119–121.10.1159/000496230CrossRefGoogle ScholarPubMed
Svicher, A, Romanazzo, S, De Cesaris, F, et al. Mental Pain Questionnaire: an item response theory analysis. J Affect Disord. 2019;249:226–233.10.1016/j.jad.2019.02.030CrossRefGoogle ScholarPubMed
Rothman, KJ. No adjustments are needed for multiple comparisons. Epidemiology. 1990;1(1):43–46.10.1097/00001648-199001000-00010CrossRefGoogle ScholarPubMed
McLean, G, Mercer, SW. Chronic migraine, comorbidity, and socioeconomic deprivation: cross-sectional analysis of a large nationally representative primary care database. J Comorb. 2017;7(1):89–95.10.15256/joc.2017.7.114CrossRefGoogle ScholarPubMed
Demjen, S, Bakal, D. Illness behavior and chronic headache. Pain. 1981;10(2):221–229.10.1016/0304-3959(81)90197-4CrossRefGoogle ScholarPubMed
Huber, D, Henrich, G. Personality traits and stress sensitivity in migraine patients. Behav Med. 2003;29(1):4–13.10.1080/08964280309596169CrossRefGoogle ScholarPubMed
Kokonyei, G, Szabo, E, Kocsel, N, et al. Rumination in migraine: mediating effects of brooding and reflection between migraine and psychological distress. Psychol Health. 2016;31(12):1481–1497.10.1080/08870446.2016.1235166CrossRefGoogle ScholarPubMed
Vo, P, Fang, J, Bilitou, A, et al. Patients’ perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom. J Headache Pain. 2018;19(1):1–11.10.1186/s10194-018-0907-6CrossRefGoogle ScholarPubMed
Williams, DE, Raczynski, JM, Domino, J, et al. Psychophysiological and MMPI personality assessment of headaches: an integrative approach. Headache. 1993;33(3):149–154.CrossRefGoogle ScholarPubMed
Ashina, S, Bendtsen, L, Buse, DC, et al. Neuroticism, depression and pain perception in migraine and tension-type headache. Acta Neurol Scand. 2017;136(5):470–476.CrossRefGoogle ScholarPubMed
Chu, HT, Liang, CS, Lee, JT, et al. Associations between depression/anxiety and headache frequency in migraineurs: a cross-sectional study. Headache. 2018;58(3):407–415.10.1111/head.13215CrossRefGoogle ScholarPubMed
Moon, HJ, Seo, JG, Park, SP. Perceived stress in patients with migraine: a case-control study. J Headache Pain. 2017;18(1):73.10.1186/s10194-017-0780-8CrossRefGoogle ScholarPubMed
Stuginski-Barbosa, J, Dach, F, Bigal, M, et al. Chronic pain and depression in the quality of life of women with migraine—a controlled study. Headache. 2012;52(3):400–408.10.1111/j.1526-4610.2012.02095.xCrossRefGoogle ScholarPubMed
Krøll, LS, Hammarlund, CS, Westergaard, ML, et al. Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain. J Headache Pain. 2017;18(1):46.10.1186/s10194-017-0753-yCrossRefGoogle ScholarPubMed
Piolanti, A, Gostoli, S, Gervasi, J, et al. A trial integrating different methods to assess psychosocial problems in primary care. Psychother Psychosom. 2019;88(1):30–36.10.1159/000496477CrossRefGoogle ScholarPubMed
Strine, TW, Chapman, DP, Balluz, LS. Population-based U.S. study of severe headaches in adults: psychological distress and comorbidities. Headache. 2006;46(2):223–232.10.1111/j.1526-4610.2006.00340.xCrossRefGoogle ScholarPubMed
Peres, MFP, Mercante, JPP, Tobo, PR, et al. Anxiety and depression symptoms and migraine: a symptom-based approach research. J Headache Pain. 2017;18(1):1–8.CrossRefGoogle ScholarPubMed
Seng, EK, Buse, DC, Klepper, JE, et al. Psychological factors associated with chronic migraine and severe migraine-related disability: an observational study in a tertiary headache center. Headache. 2017;57(4):593–604.CrossRefGoogle Scholar
Cosci, F, Fava, GA. The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model. CNS Spectr. 2016;21:310–317.10.1017/S1092852915000760CrossRefGoogle ScholarPubMed
Hagen, K, Åsberg, AN, Stovner, L, et al. Lifestyle factors and risk of migraine and tension-type headache. Follow-up data from the Nord-Trøndelag Health Surveys 1995-1997 and 2006-2008. Cephalalgia. 2018;38(13):1919–1926.CrossRefGoogle ScholarPubMed
Varkey, E, Hagen, K, Zwart, JA, et al. Physical activity and headache: results from the Nord-Trøndelag Health Study (HUNT). Cephalalgia. 2008;28(12):1292–1297.10.1111/j.1468-2982.2008.01678.xCrossRefGoogle Scholar
Fattahzadeh-Ardalani, G, Aghazadeh, V, Atalu, A, et al. Somatoform dissociation, fatigue severity and pain behavior compared in patients with migraine headache and in healthy individuals. Neurol Int. 2017;9(2):7015CrossRefGoogle Scholar
Kelman, L. The triggers or precipitants of the acute migraine attack. Cephalalgia. 2007;27(5):394–402.10.1111/j.1468-2982.2007.01303.xCrossRefGoogle ScholarPubMed
Vgontzas, A, Pavlović, JM. Sleep disorders and migraine: review of literature and potential pathophysiology mechanisms. Headache. 2018;58(7):1030–1039.CrossRefGoogle ScholarPubMed
Fuller-Thomson, E, Schrumm, M, Brennenstuhl, S. Migraine and despair: factors associated with depression and suicidal ideation among Canadian migraineurs in a population-based study. Depress Res Treat. 2013;2013:401487Google ScholarPubMed
Slater, E, Slater, P. A heuristic theory of neurosis. J Neurol Psychiatry. 1944;7(1-2):49–55.CrossRefGoogle ScholarPubMed
Buse, DC, Silberstein, SD, Manack, AN, Papapetropoulos, S, Lipton, RB. Psychiatric comorbidities of episodic and chronic migraine. J Neurol. 2013;260(8):1960–1969.10.1007/s00415-012-6725-xCrossRefGoogle ScholarPubMed
Guidi, J, Piolanti, A, Gostoli, S, et al. Mental pain and euthymia as transdiagnostic clinimetric indices in primary care. Psychother Psychosom. 2019;88(4):252–253.10.1159/000501622CrossRefGoogle ScholarPubMed
Yager, J. Addressing patients’ psychic pain. Am J Psychiatry. 2015;172(10):939–943.CrossRefGoogle ScholarPubMed
Buse, DC, Scher, AI, Dodick, DW, et al. Impact of migraine on the family: perspectives of people with migraine and their spouse/domestic partner in the CaMEO Study. Mayo Clin Proc. 2016;25:S0025-6196Google Scholar
Pine, DS, Cohen, P, Brook, J. The association between major depression and headache: results of a longitudinal epidemiologic study in youth. J Child Adolesc Psychopharmacol. 1996;6(3):153–164.10.1089/cap.1996.6.153CrossRefGoogle ScholarPubMed
Tietjen, GE, Brandes, JL, Peterlin, BL, et al. Childhood maltreatment and migraine (part II). Emotional abuse as a risk factor for headache chronification. Headache. 2010;50(1):32–41.CrossRefGoogle ScholarPubMed
Onderwater, GLJ, van Oosterhout, WPJ, Schoonman, GG, et al. Alcoholic beverages as trigger factor and the effect on alcohol consumption behavior in patients with migraine. Eur J Neurol . 2019;26(4):588–595.10.1111/ene.13861CrossRefGoogle ScholarPubMed
Roy, R. Marital and family issues in patients with chronic pain. A review. Psychother Psychosom. 1982;37(1):1–12.10.1159/000287549CrossRefGoogle ScholarPubMed
Gooddy, W. On the nature of pain. Brain. 1957;80:118–131.10.1093/brain/80.1.118CrossRefGoogle ScholarPubMed
Lobitz, G, Armstrong, K, Concato, J, et al. The biological and biographical basis of precision medicine. Psychother Psychosom. 2019;88(6):333–340.10.1159/000502486CrossRefGoogle ScholarPubMed
Bech, P. Clinical Psychometrics. Oxford, UK: Wiley Blackwell; 2012.CrossRefGoogle Scholar