Female migraine patients had lower COVID-19 phobia and PCL-5 scores during the lockdown period

Abstract

Background To examine the impact of the lockdown period of the pandemic on COVID-19 phobia and post-traumatic stress disorder (PTSD) in migraine patients. Methods A total of 73 patients, including 39 migraine and 34 controls, completed the study during the lockdown period. The patients were evaluated using the Structured Headache Questionnaire, PTSD Checklist for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) (PCL-5) and COVID-19 Phobia Scale via the telephone-based telemedicine method. Results Migraine patients had significantly lower scores in all subgroups of the COVID-19 Phobia Scale (mean = 42.33 ± 12.67) than those in the healthy control group (mean = 52.88 ± 13.18). PCL-5 scale scores in migraine patients were significantly lower (mean = 27.18 ± 14.34) compared to the healthy controls (Mean = 34.03 ± 14.36). Migraine attack frequency decreased or did not change in 67% of the patients during the lockdown period. Conclusion Acute stress response to an extraordinary situation such as a pandemic may be more controlled in migraine patients, yet specific phobia and post-traumatic stress disorder have been reported more frequently in patients with migraine under normal living conditions. We interpreted that the life-long headache-associated stress may generate a tendency to resilience and resistance to extraordinary traumatic events in migraine patients.

Posttraumatic stress disorder is a risk factor for migraine: two-sample Mendelian randomization and bioinformatic analysis

“…However, a study examining COVID-19 phobia and PTSD PCL-5 scale scores in migraine patients during lockdown concluded that both fear scores and PTSD PCL-5 scale scores in migraine patients were signi cantly lower than those in healthy controls. The study suggested that acute stress responses to abnormal situations among migraine patients during the COVID-19 pandemic may not be as pronounced as those seen in healthy controls [10]. We need to emphasize, in particular, that while speci c phobias and PTSD are more prevalent among migraine patients under normal living conditions, we hypothesize that migraine patients may exhibit greater resilience to unpredictable panic events.…”

“…The causal association between PTSD and migraine was considered positive if all tests of multiplicity were p > 0.05 and the leave-one-out test showed stable MR estimates. All the statistical tests were performed by the "Two Sample MR" package [23] (version 0.5.7) and the "MR-PRESSO" package (10) in R software (version 4.2.3).…”

“…PTSD is recognized as a signi cant risk factor for migraine, resulting in an elevated prevalence of migraine and increased utilization of antimigraine medications [8]. In addition, migraine may be aggravated by PTSD [9], and a retrospective study revealed that 47.3% (105 out of 222) of migraine patients experienced an increase in the frequency of headache days during the COVID-19 lockdown, which was found to be associated with symptoms of PTSD [10].…”