SAN FRANCISCO – Nearly 1 in 10 chronic migraine patients say they’ve delayed having children or had fewer children because of their headaches, according to a new analysis from the CaMEO study.
Bruce Jancin/MDedge News
Dr. Dawn C. Buse
“I think this is the most heartbreaking of the survey responses; we asked, ‘Have you delayed having children or had fewer children because of your headaches?’ and 2.6% of patients with episodic migraine and 9.6% with chronic migraine said yes,” Dawn C. Buse, PhD, said at the annual meeting of the American Headache Society.
CaMEO (the Chronic Migraine Epidemiology and Outcomes study) is a longitudinal, prospective, Internet-based survey whose aim is to flesh out the full impact of migraine. Dr. Buse presented an analysis of 13,064 migraineur participants, which focused on the impact of migraine on intimate relationships and parenting, an aspect of the disease burden that hasn’t been closely examined. All subjects completed the in-depth Family Burden Module, which is concerned with the emotional consequences of migraine.
The bottom line is that “migraine has significant negative impact on the most important relationships in our life: with our spouses, partners, and children,” declared Dr. Buse, a clinical psychologist at the Albert Einstein College of Medicine and director of behavioral medicine for the Montefiore Headache Center in New York.
The extent to which migraineurs perceived their headaches to be a problem increased stepwise with their number of headache days per month. For example, when the 8,127 CaMEO participants in a relationship with a live-in partner were asked to respond to the statement, “If I did not have headaches, I would be a better partner,” somewhat or complete agreement was endorsed by 38% of those with low-frequency episodic migraine at a rate of up to 4 headache days per month, 68% of those with 5-9 headache days per month, 73% of those with high-frequency episodic migraine with 10-14 headache days per month, and 78% of those with chronic migraine, defined as 15 or more headache days per month.
“Not surprising, certainly, but something to keep in mind as we care for our patients; that just because someone has episodic migraine they may have a range of expressions of how much those migraines have impacted their life,” Dr. Buse observed.
Another example: The proportion of subjects who reported delaying having children or having fewer kids because of their headaches was 1.6%, 5.5%, and 6.5% in low-, moderate-, and high-frequency episodic migraineurs, respectively, before topping out at 9.6% among those with chronic migraine.
Although she and her coinvestigators broke down the data by gender, there were no significant gender differences in the impact of migraine on significant relationships. The major differences were between patients with episodic as compared with chronic migraine.
Among the more than 3,500 CaMEO participants not currently in a relationship, 37% of those with chronic migraine and 15% of those with episodic migraine indicated that their headaches had contributed to relationship problems.
Of those in a relationship but not living together, 44% of individuals with chronic migraine reported that their headaches were preventing a closer relationship, such as moving in together or getting married, as did 16% of those with episodic migraine.
About 47%of respondents with chronic migraine reported that their headaches had caused at least one previous break-up, as did 18% of those with episodic migraine.
“Health care professionals should consider the overall burden of disease when managing migraine, particularly for those with chronic migraine,” Dr. Buse concluded. “Personalized comprehensive treatment plans may include both acute and preventive pharmacologic treatments as well as behavioral treatment for the proband, marital dyad, and family members as appropriate.”
She reported receiving research support and honoraria from Allergan, the study sponsor, as well as from Avenir, Eli Lilly, and Promius.
SOURCE: Buse DC et al. AHS 2018, Abstract OR06.