Recalled maltreatment, migraine, and tension-type headache Results of the AMPP Study
Recalled maltreatment, migraine, and tension-type headache Results of the AMPP Study
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DOI：
10.1212/wnl.0000000000001120
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发表时间：
2015-01-13
期刊：
影响因子：
9.9
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
--
作者：
Tietjen, Gretchen E.;Buse, Dawn C.;Lipton, Richard B.
目的：探讨童年不良回忆(ACEs)与偏头痛和发作性紧张型头痛(ETTH)的关系。方法：对2007年美国偏头痛流行与预防研究调查对象中的ACEs进行横断面分析。我们使用Logistic回归对头痛类型进行建模，调整了社会人口学变量(年龄、种族、性别、收入)、抑郁和焦虑，以及使用比例优势模型的有序Logistic回归分析头痛天数。结果：参与者患有偏头痛(n=8,305)或ETTH(n=1,429)。偏头痛患者在情感忽视(24.5%比21.5%)、情感虐待(22.5%比16.7%)和性虐待(17.7%比13.3%)方面的ACE发生率显著高于ETTH。在调整社会人口学因素后，情感忽视(优势比[OR]=1.23，95%可信区间[CI]1.07-1.42)、情感虐待(OR=1.46，95%可信区间1.25-1.71)或性虐待(OR=1.35，95%可信区间1.11-1.62)的患者患偏头痛与ETTH的风险显著增加。结果仅对情绪虐待有显著意义(OR=1.33，95%CI为1.13~1.57)。2(OR 1.52，95%CI 1.25-1.86)与1(OR 1.17，95%CI 1.00-1.36)ACE相比偏头痛的风险更高，在调整了抑郁和焦虑因素后保持不变。在偏头痛患者中，所有形式的虐待都与较高的头痛日数类别相关，但在调整抑郁和焦虑因素后，结果没有统计学意义。结论：ACE与偏头痛的风险高于ETTH。抑郁和焦虑对ACEs的影响减弱意味着混淆或调解，尽管情绪虐待的结果通常保持不变。
Objective: To examine the relationship of recalled adverse childhood experiences (ACEs) with migraine and episodic tension-type headache (ETTH).Methods: We conducted a cross-sectional analysis of ACEs among 2007 American Migraine Prevalence and Prevention Study survey respondents with ETTH and migraine. We modeled headache type using logistic regression adjusting for sociodemographic variables (age, race, sex, income), depression, and anxiety, and headache day frequency using ordinal logistic regression with a proportional odds model.Results: Participants had migraine (n = 8,305) or ETTH (n = 1,429). Rates of ACEs were significantly higher among respondents with migraine than ETTH for emotional neglect (24.5% vs 21.5%), emotional abuse (22.5% vs 16.7%), and sexual abuse (17.7% vs 13.3%). Odds of migraine vs ETTH were significantly higher for those reporting emotional neglect (odds ratio [OR] = 1.23, 95% confidence interval [CI] 1.07-1.42), emotional abuse (OR = 1.46, 95% CI 1.25-1.71), or sexual abuse (OR = 1.35, 95% CI 1.11-1.62) when adjusted for sociodemographics. Results remained significant only for emotional abuse when adjusting for depression and anxiety (OR = 1.33, 95% CI 1.13-1.57). Odds of migraine were higher with 2 (OR 1.52, 95% CI 1.25-1.86) vs 1 (OR 1.17, 95% CI 1.00-1.36) ACE, which held after adjusting for depression and anxiety. All forms of maltreatment were associated with higher headache day frequency category in migraine but results lost significance after adjusting for depression and anxiety.Conclusions: ACEs are associated with a higher risk of migraine vs ETTH. Attenuation of the influence of ACEs by depression and anxiety suggests confounding or mediation, although results for emotional abuse were generally maintained.