A cross-sectional study on the personality traits of episodic and chronic migraine patients

Migraine is defined as a neurovascular syndrome presenting with headache and seen in people with genetic predisposition triggered by various factors. It is observed with different neuropsychiatric findings [30]. As headaches progress from the episodic to the chronic form, the incidence of accompanying personality disorders increases [40]. It is considered that coexisting psychiatric conditions are essential factors in the chronicity of migraine. This situation increases the incidence of medication overuse headaches in patients with migraine [13], [32].

It has been reported that depression, anxiety and other chronic pains can be seen more frequently during the chronicity of migraine [35]. Besides, it has been revealed that migraine patients' tendencies to suppress their emotions are higher than healthy individuals [22,29]. The idea of personality traits specific to migraine patients emerged upon observation of highly distinct common characteristics of patients applying to clinics. The first comprehensive explanation of this subject revealed migraine patients' perfectionist, strict, organized, ambitious, and competitive traits [39]. Recent studies reported that migraine patients showed higher depression and anxiety levels, hypochondriac tendencies, and self-aggression as a defense mechanism than healthy individuals [4], [20], [38]. Wolf et al. said that the research on migraine headaches could lead to future research on the personality traits of migraine sufferers [39].

It is shown that the personality profile assessed with the Minnesota Multiphasic Personality Inventory (MMPI) is an important component of headache disorders [15] and can determine the prognosis and a variety of treatment considerations [12]. In the research examining personality dimensions of migraine patients, it has been reported that scores of migraine patients for avoiding damage and persisting were higher, and their novelty search scores were lower than those of healthy individuals [7]. In a limited number of studies where personality traits of headache cases were assessed with the MMPI scale, it has been reported that hypochondriasis, depression, and social introversion scores were significantly different compared with standard samples. It has been suggested that these personality traits may negatively affect the treatment and may cause overuse of analgesics due to pain [3], [9]. When the relation between this differentiation and depression is examined, it has been found that scores for avoiding damage had a strong relationship with depression while scores for persisting were utterly related to migraine [23]. These results support the idea of a "migraine personality" prone to emotional strictness and obsession. Some publications suggest that personality traits related to a neurotransmitter dysfunction comprised the psychobiological component of migraine [1].

Most cases with chronic daily headaches were assessed in studies researching personality traits of cases with a headache until today, and the studies conducted between episodic migraine (EM) and chronic migraine (CM patients) and control groups without headaches are limited. Our study aims to determine the clinical, demographic, and personality traits of migraineurs, research the role of these personality traits in the chronicization of migraine headaches, and compare the obtained data with healthy volunteers. This research has helped plan future studies on migraine and personality, as other studies did not have a control group or good measurement tools. Thanks to a comprehensive evaluation, unnecessary and inadequate treatments and an increase in work and economic burden can be prevented.

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