WASHINGTON, DC—While migraine is debilitating on an individual and societal level, its effects on the entire family can be substantial, as well. In a survey of migraineurs and their spouse/partners, migraine was found to impact family activities, inspire worries about financial security, and influence the nature of personal interactions. Lead author Dawn C. Buse, PhD, Associate Professor of Clinical Neurology at Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, New York, reported the study results at the American Headache Society’s 57th Annual Meeting. The study also assessed differences in family impact based on headache frequency. Previously, there had been little data to shed light on this topic.
Dawn C. Buse, PhD
Online Search for Study Participants In an attempt to represent US population demography, the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study used Web-based cross-sectional modules to identify potential participants from a panel of 2.4 million people. Dr. Buse and her research colleagues sent e-mail invitations to nearly 490,000 individuals who met study criteria—namely, meeting criteria for migraine using the American Migraine Study/American Migraine Prevalence and Prevention Study Diagnostic Module and chronic migraine using modified Silberstein-Lipton criteria. In addition to the migraine respondents (probands), their spouse/partners (a spouse, partner, or significant other living in the same household for ≥ 2 months) also were invited to participate.
Categories for headache days per month were divided into low-, moderate-, and high-frequency episodic migraine: 0 to 4, 5 to 9, and 10 to 14, respectively. Chronic migraine was defined as 15 or more headache days per month. The number of headache days per month was averaged over the preceding 90 days.
Survey items assessed four domains of interest: reduced participation in family activities, missed or canceled events, financial impact, and spouse interactions. Reduced participation and missed or canceled events were assessed on a Likert-type scale ranging from 1 (disagree completely) to 4 (agree completely).
After determining usable returns, the researchers included responses for 4,022 proband-spouse dyads in the final analysis. Of the probands, 73.3% were women and 72.9% of spouses were men. The mean age of probands and spouses were 43 and 44, respectively; 14.6% of participants were nonwhite.
Disrupted Relationships
Nearly half of probands (49.4%) on average reported not participating in family activity at home because of headache in the past 30 days, and nearly a third (29.8%) of their spouses reported not participating due to the proband’s headache. A total of 53.5% and 33.6% of probands and spouses, respectively, reported reduced enjoyment in family activity more than once during the past 30 days, and 51.4% and 53.6%, respectively, reported that one-on-one time was disrupted more than once during the past month due to the proband’s headaches.
On average, one in five probands reported missing a holiday or religious event due to headache. The frequency of that response among those with chronic migraine was four times that of those with low-frequency episodic migraine (0 to 4 headache days per month)—40.8% vs 10.7%, respectively. About 38% of probands with chronic migraine and 32% of spouses reported canceling an important celebration at home in the past month. Nearly 40% of probands with chronic migraine and 29% of spouses reported missing a wedding, graduation, retirement celebration, or other important event.
Worry about covering household expenses or about being fired or laid off from a job was prevalent among probands and spouses. Such concern increased with increased headache frequency. The researchers noted that as many as a quarter of probands with low-frequency episodic migraine worried about overall long-term financial security, as did 59.5% of those with chronic migraine.
About one-third of all spouses and nearly half of spouses of those with chronic migraine reported avoiding the proband because of headache. About 24% of probands with 0 to 4 headaches per month and 44% of those with chronic migraine had the perception that their spouses do not believe them about their headaches.
“The CaMEO Study results offer a unique view into migraine impact because both the probands’ and spouses’ perspectives were gathered,” the researchers said. “Existing data and clinical experience suggest that the impact of migraine is pervasive and extends beyond the individual with migraine.”
—Adriene Marshall