Association Between Intimate Partner Violence, Migraine and Probable Migraine

Department of Epidemiology, University of Washington, Seattle, WA 98195-7236, USA.
Headache The Journal of Head and Face Pain (Impact Factor: 2.71). 10/2010; 51(2):208-19. DOI: 10.1111/j.1526-4610.2010.01777.x
Source: PubMed


Intimate partner violence (IPV) among women is a global public health problem. The association between childhood maltreatment and migraine is well established, but not the association between IPV and migraine. The aim of this cross-sectional study was to evaluate the relationship between type and severity of IPV and migraine in a large cohort of Peruvian women.
Women who delivered singleton infants (n = 2066) at the Instituto Nacional Materno Perinatal, Lima, Peru were interviewed during their postpartum hospital stay. Participants were queried about their lifetime experiences with headaches and migraine, and with physical and sexual violence. The International Classification of Headache Disorders (ICHD-2) diagnostic criteria were used to classify participants according to their migraine status. Questions on physical and sexual violence were adapted from the protocol of Demographic Health Survey Questionnaires and Modules: Domestic Violence Module and the World Health Organization (WHO) Multi-Country Study on Violence against Women. Depressive symptoms were assessed using a modified version of the Patient Health Questionnaire-9. Logistic regression was used to estimate multivariate adjusted odds ratios (aOR) and 95% confidence intervals (CI).
Compared with women without a history of violence, women with experiences of lifetime physical or sexual violence (aOR = 1.44, 95% CI 1.19-1.75), physical violence only (aOR = 1.36, 95% CI 1.10-1.68), sexual violence only (aOR = 1.76, 95% CI 0.97-3.21), and both physical and sexual violence (aOR = 1.61, 95% CI 1.12-2.31) had increased odds of any migraine after adjusting for maternal age, parity, and access to basic foods. There was no gradient of increased odds of any migraine with severity of physical violence. The relationship between IPV and any migraine was strongest among women with moderate to severe levels of depressive symptoms. The odds of any migraine was increased 2.25-fold (95% CI 1.75-2.28) among abused women who also had moderate to severe levels of depressive symptomology compared with women who were not abused and had none or mild levels of depressive symptomology. Associations from sensitivity analyze that segregated women according to probable migraine (ICHD-2 category 1.6.1) and migraine (ICHD-2 category 1.1) diagnoses were of similar magnitudes as those reported here for women with any migraine diagnoses. IPV, particularly sexual violence, appears to be a risk factor for migraine.
Our findings suggest the potential importance of considering a history of violence among migraineurs.

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    • "In the current data, headache was not classified by formal International Classification of Headache Disorders (ICHD-2) diagnostic guidelines, as have been used in other studies (Peterlin et al., 2007, 2008, 2009; Peterlin, Rosso, et al., 2011; Cripe et al., 2011), because the authors felt that this information was often not available to primary care providers seeing women patients, and because the MIDAS has been validated in both tension variant and migraine headaches (Stewart, Lipton, Kolodner, et al., 1999). However, this limited the ability to compare current findings to those of other studies that have stratified their results by headache type. "
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