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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*
Department of Health Science, University of Florence, Florence, Italy Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands
Andrea Svicher
Department of Health Science, University of Florence, Florence, Italy
Giovanni Mansueto
Department of Health Science, University of Florence, Florence, Italy
Silvia Benemei
Headache and Clinical Pharmacology Center, Careggi University Hospital, Florence, Italy
Alberto Chiarugi
Department of Health Science, University of Florence, Florence, Italy Headache and Clinical Pharmacology Center, Careggi University Hospital, Florence, Italy
Francesco De Cesaris
Headache and Clinical Pharmacology Center, Careggi University Hospital, Florence, Italy
Jenny Guidi
Department of Psychology, University of Bologna, Bologna, Italy
Stephan Zipfel
Department of Psychosomatic Medicine, University of Tübingen, Tübingen, Germany
Author for correspondence: Fiammetta Cosci, MD, MSc, PhD Email:



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.


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.


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).


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.

Original Research
© The Author(s), 2020. Published by Cambridge University Press

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