Acceptance, Psychiatric Symptoms, and Migraine Disability: An Observational Study in a Headache Center.
Acceptance, Psychiatric Symptoms, and Migraine Disability: An Observational Study in a Headache Center.
复制标题
接受度、精神症状和偏头痛障碍：头痛中心的观察性研究。
作者：
Seng,ElizabethK;Kuka,AlexanderJ;Mayson,SarahJo;Smitherman,ToddA;Buse,DawnC
目的评估在三级头痛护理中心就诊的偏头痛患者的精神症状、接受度和偏头痛相关残疾之间的关系。尽管在其他疼痛条件下有很强的理论基础和证据，但对接受、精神症状和偏头痛相关残疾之间的关系知之甚少。方法90名医生诊断的偏头痛患者完成了调查，评估了人口统计学、头痛症状、与偏头痛相关的严重残疾(偏头痛残疾评定量表总分在 ≥ 21中分成两部分)、抑郁(患者健康问卷-9)和焦虑症状(广泛性焦虑障碍-7)，以及接受(慢性疼痛接受问卷；子量表：疼痛意愿和活动投入)。50.0%的患者具有研究生学历)报告的平均头痛强度为6.7/10(SD = 2.0)。三分之一(36.0%)的人报告患有慢性偏头痛，一半(51.5%)的人报告与偏头痛相关的严重残疾。较低的接受度与严重的偏头痛相关残疾有关，t(54) = 4.13，P<； .001。较高的活动参与度与较低的平均头痛疼痛强度相关(r= −.30，P= .011)。较高的接受度与较低的抑郁(r= −.48，P<； .001)和焦虑症状(r= −.37，P= .003)相关。疼痛意愿和活动投入在抑郁症状和严重偏头痛相关残疾之间(间接效应 = 0.0 5，95%CI = 0.0 1，0.15)和焦虑症状与严重偏头痛相关残疾之间(间接效应 = 0.12，95%CI = 0.0 2，0.31)之间的关系起到中介作用。
ObjectiveTo evaluate relationships between psychiatric symptoms, acceptance, and migraine‐related disability in a sample of people with migraine presenting at a tertiary care headache center.BackgroundMigraine is a chronic disease that can be severely disabling. Despite a strong theoretical basis and evidence in other pain conditions, little is known about relationships between acceptance, psychiatric symptoms, and migraine‐related disability.MethodsNinety patients with physician‐diagnosed migraine completed surveys assessing demographics, headache symptoms, severe migraine‐related disability (Migraine Disability Assessment Scale total score dichotomized at ≥ 21), depression (Patient Health Questionnaire‐9) and anxiety symptoms (Generalized Anxiety Disorder‐7), and acceptance (Chronic Pain Acceptance Questionnaire; subscales: Pain Willingness and Activity Engagement).ResultsParticipants (77.8% white, non‐Hispanic; 85.6% women; and 50.0% with a graduate level education) reported an average headache pain intensity of 6.7/10 (SD = 2.0). One‐third (36.0%) reported chronic migraine, and half (51.5%) reported severe migraine‐related disability. Lower acceptance was associated with severe migraine‐related disability, t(54) = 4.13,P< .001. Higher activity engagement was associated with lower average headache pain intensity (r= −.30,P= .011). Higher acceptance was associated with lower levels of depression (r= −.48,P< .001) and anxiety symptoms (r= −.37,P= .003). Pain willingness and activity engagement serially mediated relationships between depression symptoms and severe migraine‐related disability (indirect effect = 0.05, 95% CI = 0.01, 0.15), and between anxiety symptoms and severe migraine‐related disability (indirect effect = 0.12, 95% CI = 0.02, 0.31).ConclusionResults provided preliminary support for a theoretical pathway by which psychiatric symptoms may influence migraine‐related disability, in part, through their relationships with pain willingness and activity engagement.