• Myoung-Jin Cha, Byung-Kun Kim, Heui-Soo Moon, Jin-Young Ahn, Kyungmi Oh, Jee Young Kim, Byung-Su Kim, Jong-Hee Sohn, Jae-Myun Chung, Tae-Jin Song, Jiyoung Kim, Jong-Geun Seo, Min Kyung Chu, and Soo-Jin Cho.
• Department of Neurology, National Police Hospital, Seoul, Korea.
• Pain Med. 2018 Sep 1; 19 (9): 1832-1838.

BackgroundChronic migraine (CM) is associated with severe psychological symptoms and disabilities. Information on the relationship between stress and the outcomes of acute CM treatment is limited.MethodsWe evaluated the clinical presentation and stress levels of patients with CM who visited the neurology departments of 14 hospitals between September and December 2015. The patients were divided into stress and reference groups on the basis of the Korean version of the Brief Encounter Psychosocial Instrument (BEPSI-K). Quality of life was evaluated using EuroQol Five Dimension Questionnaire Three-Level. The Migraine Assessment of Current Therapy questionnaire was used to assess the outcomes of acute treatment.ResultsThis study included 186 CM patients. On the basis of the BEPSI-K score, 79 and 107 patients were assigned to the stress and reference groups, respectively. The stress group had more patients with poor outcomes of acute treatment than the reference group (67.1% vs 40.2%, P < 0.001). In a multivariate analysis, female gender (odds ratio [OR] = 3.266, 95% confidence interval [CI] = 1.172-9.103, P = 0.024), the number of headache-free days per month (OR = 0.932, 95% CI = 0.883-0.985, P = 0.012), and BEPSI-K score (OR = 1.667, 95% CI = 1.051-2.643, P = 0.030) predicted poor outcomes of acute treatment.ConclusionsHigh levels of stress were reported by 42.5% of patients with CM. The association between stress and the outcomes of acute treatment suggests that stress is an important clinical variable for improving the management of CM.

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