Catastrophization is related to the patient and not to the severity of migraine

ABSTRACT

Background: Catastrophization is a psychological aspect of pain that alters its perception and expression. Objective: To investigate the feature of catastrophization in migraine. Methods: An online survey of individuals suffering from migraine attacks at least twice a month, for at least one year was carried out. Confidentiality was assured and participants gave details of their headache (including a visual analogue pain scale) and answered the Hospital Anxiety and Depression Scale and the Catastrophization Scale questionnaires. Results: The survey included 242 individuals with migraine attacks at least twice a month. The median scores observed in this group of individuals were 7 for pain, 11 for anxiety, 7 for depression, and 2 for catastrophization. Catastrophization had no correlation with the duration (p=0.78) or intensity (p=0.79) of the migraine. There was no correlation between catastrophization and headache frequency (p=0.91) or the monthly amount of headache medication taken (p=0.85). High scores for catastrophization (≥3.0) were identified in one third of the participants. These high scores were not associated with age, headache duration, pain severity, frequency of attacks, or traits of depression or anxiety. There was a moderate association between both depression and anxiety traits with catastrophization. Conclusions: Catastrophization seems to be a trait of the individual and appears to be unrelated to the characteristics of the migraine.

RESUMO

Antecedentes: A catastrofização é um aspecto psicológico da dor, alterando sua percepção e expressão. Objetivos: Investigar o fenômeno da catastrofização na enxaqueca. Métodos: Pesquisa online com indivíduos que sofrem de crises de enxaqueca pelo menos duas vezes por mês, por pelo menos um ano. O sigilo foi assegurado. O participante dava detalhes de sua dor de cabeça (incluindo escala de dor analógica visual) e respondeu à Escala de Ansiedade e Depressão Hospitalar e à Escala de Catastrofização. Resultados: A pesquisa identificou 242 indivíduos com ataques de enxaqueca pelo menos duas vezes por mês. Os escores medianos observados neste grupo de indivíduos foram 7 para dor, 11 para ansiedade, 7 para depressão e 2 para catastrofização. Catastrofização não teve correlação com a duração (p=0,78) ou intensidade (p=0,79) da dor na crise de enxaqueca. Não houve correlação entre catastrofização e frequência de crises (p=0,91) ou quantidade mensal de medicação usada para tratar a cefaleia (p=0,85). Foram identificados escores elevados para catastrofização (≥3,0) em um terço dos participantes. Esses escores elevados não foram associados à idade, duração da dor de cabeça, gravidade da dor, frequência de ataques e traços de depressão ou de ansiedade. Houve moderada associação entre casos com concomitante depressão e ansiedade e catastrofização. Conclusões: A catastrofização parece ser um traço do indivíduo e parece não estar relacionada às características da enxaqueca.

Keywords:

Headache - Migraine - Catastrophization - Pain

Palavras-chave:

Cefaleia - Enxaqueca - Catastrofização - Dor

Authors’ contribution:

EGN: study design, supervision, data collection and analyses; FRO: data collection, discussion of results; VMC: data collection, discussion of results; CT: study design, discussion of results; YDF: lead study design, lead supervision, data analyses and writing the manuscript.

Publication History

Received: 01 October 2020

Accepted: 10 November 2020

Article published online:
01 June 2023

• References

• 1 Peres MFP, Mercante JPP, Guendler VZ, Corchs F, Bernick MA, Zukerman E, et al. Cephalalgiaphobia: a possible specific phobia of illness. J Headache Pain. 2007 Feb;8(1):56-9. https://doi.org/10.1007/s10194-007-0361-3
• 2 Kapoor S, Thorn BE, Bandy O, Clements KL. Pain referents used to respond to the pain catastrophizing scale. Eur J Pain. 2015 Mar;19(3):400-7. https://doi.org/10.1002/ejp.561
• 3 Severeijns R, Vlaeyen JW, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001 Jun;17(2):165-72. https://doi.org/10.1097/00002508-200106000-00009
• 4 Bag B, Hacihasanoglu R, Tufekci FG. Examination of anxiety, hostility, and psychiatric disorders in patients with migraine and tension-type headache. Int J Clin Pract. 2005 May;59(5):515-21. https://doi.org/10.1111/j.1368-5031.2005.00522.x
• 5 Alvarez-Astorga A, García-Azorín D, Hernández M, de la Red H, Sotelo E, Uribe F, et al. Pain catastrophising in a population of patients with migraine. Neurologia (Engl Ed). 2021 Jan-Feb;36(1):24-8. https://doi.org/10.1016/j.nrl.2018.10.005
• 6 International Headache Society.Headache classification committee of the international headache society (IHS) The international classification of headache disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. https://doi.org/10.1177/0333102417738202
• 7 Snaith RP. The hospital anxiety and depression scale. Health Qual Life Outcomes. 2003 Aug 1;1:29. https://doi.org/10.1186/1477-7525-29
• 8 Pais-Ribeiro J, Silva I, Ferreira T, Martins A, Meneses R, Baltar M. Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychol Health Med. 2007 Mar;12(2):225-37. https://doi.org/10.1080/13548500500524088
• 9 Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7(4):524-32. https://doi.org/10.1037/1040-3590.7.4.524
• 10 Sehn F, Chachamovich E, Vidor LP, Dall-Agnol L, Custódio de Souza IC, Torres ILS, et al. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the pain catastrophizing scale. Pain Med. 2012 Nov;13(11):1425-35. https://doi.org/10.1111/j.1526-4637.2012.01492.x
• 11 Petrovics-Balog A, Majláth Z, Melinda L, Holczer A, Must A, Tajti J, et al. The effect of psychiatric comorbidities and stress-coping strategies on perceived quality of life in migraine. Ideggyogy Sz. 2019 Nov 30;72(11-12):397-404. https://doi.org/10.18071/ISZ.72.0397
• 12 Malfliet A, Coppieters I, Van Wilgen P, Kregel J, De Pauw R, Dolphens M, et al. Brain changes associated with cognitive and emotional factors in chronic pain: a systematic review. Eur J Pain. 2017 May;21(5):769-86. https://doi.org/10.1002/ejp.1003
• 13 Sciruicchio V, Simeone M, Barbaro MGF, Tanzi RC, Delussi MD, Libro G, et al. Pain catastrophizing in childhood migraine: an observational study in a tertiary headache center. Front Neurol. 2019 Feb 15;10:114. https://doi.org/10.3389/fneur.2019.00114
• 14 Bond DS, Buse DC, Lipton RB, Thomas JG, Rathier L, Roth J, et al. Clinical pain catastrophizing in women with migraine and obesity. Headache. 2015 Jul-Aug;55(7):923-33. https://doi.org/10.1111/head.12597
• 15 Crombez G, De Paepe AL, Veirman E, Eccleston C, Verleysen G, Van Ryckeghem DML. Let´s talk about pain catastrophizing measures: an item content analysis. Peer J. 2020 Mar 4;8:e8643. https://doi.org/10.7717/peerj.8643