Frequency of Migraine, Presence of Neuropsychiatric Symptoms and Attachment Style: Comparative Study

Introduction: In assessing the associations between pain frequency and neurotic behavior, in addition to psychiatric comorbidities, a difference in attachment style was observed in which individuals with chronic and episodic migraines. This study investigated associations between migraine and neurotic traits or symptoms by comparing the personality profiles in attachment style of patients with episodic and chronic migraines. Patients and Methods: In a retrospective descriptive analysis of different classes of chronic daily headache, this study focused on a group of 120 adult migraine patients consecutively referred by a neurologist to a headache outpatient clinic. Participants were assessed using the Factorial Neuroticism Scale and were assigned to two groups according to the frequency of pain. Results: Of the 80 patients with chronic (age: 43.9 ± 13.7 years) and 40 subjects with episodic migraines (age: 37.15 ± 13 years), most (86.7%) were women and almost 90% presented neurotic symptoms. More chronic migraine patients had two (p=0.039) or more psychological disorders (p<0.0001) than subjects with episodic migraines. Dependent personality disorder (p<0.0001), anxiety, and impaired concentration and production (p=0.0008), depression, apathy and mood swings (p<0.0001), suicidal ideation (p=0.0007) and hopelessness (p<0.0001) predominated in chronic migraine. Episodic migraine patients mainly suffered from excessive independence and avoidant personality disorder (p=0.0001), reduced self-criticism, motivation, attention, perception and problem-solving attitudes in unexpected situations (p <0.0001). Conclusion: In association with the frequency of pain, the results showed opposite tendencies between episodic and chronic migraine patients in their perceptual, relational and coping strategies. Subjects with episodic migraine were affectively detached, individualistic, cold and elusive, more typical of the insecure-avoidant, self-centered attachment style. Chronic migraine subjects, on the other hand, in addition to a greater number of comorbidities, showed an expectative anxious dependent, victimized and depressed, with hopelessness and suicidal inclination, more typical of the insecure anxious-ambivalent attachment style.