Childhood abuse increases risk for migraine, depression, anxiety

Emotional and sexual abuse during childhood had a significant and direct impact on migraine, depression and anxiety outcomes in adulthood, while physical abuse did not, according to data presented at the American Academy of Neurology Annual Meeting.

“Since migraine and abuse are both also associated with depression and anxiety, and the likelihood of the migraine-abuse connection is attenuated when controlling for these conditions, the relationship of migraine, depression, and anxiety with regards to abuse has come into question,” Gretchen E. Tietjen, MD, of the University of Toledo, Ohio, told Healio.com/Psychiatry. “For instance, does abuse lead to depression and anxiety, which in turn predisposes to migraine, or does abuse lead to migraine, which in turn leads to depression and anxiety? Or are the relationships between abuse, migraine, depression and anxiety each independent?”

Gretchen E. Tietjen

To examine the effect of childhood abuse on migraine, depression and anxiety, researchers analyzed data for 14,484 adults in wave 4 of the National Longitudinal Study of Adolescent to Adult Health study. Participants reported emotional, physical and sexual abuse during childhood and diagnoses of migraine, depression and anxiety.

Fourteen percent of the cohort reported history of migraine. Childhood abuse was more common among participants with migraine compared with those with no migraine history (60.5% vs. 49%), including emotional (57.6% vs. 45.5%; P < .01), sexual (8.3% vs. 4.6%; P < .01) and physical (22.3% vs. 17.9%; P < .01).

Structural equation model analysis indicated childhood abuse had a significant direct impact on migraine, anxiety and depression outcomes through a latent abuse factor.

Subgroup analysis by race and gender indicated the same associations.

Analysis of different abuse types indicated that emotional and sexual abuse significantly affected migraine, depression and anxiety outcomes, while physical abuse did not.

“An application for our finding would be to use treatments aimed at reversing the changes in the brain caused by abuse for the subset of persons with migraine, or at least to better understand the mechanisms of these therapies as they relate to the migraine brain,” Tietjen said. “Such treatments which have been studied in abuse-related psychiatric conditions include cognitive behavioral therapies, selective serotonin reuptake inhibitors, and histone deacetylase (HDAC) inhibitors (which act on epigenetic changes cause by abuse). Two HDAC inhibitors, valproic acid and topiramate, are, interestingly, both FDA approved for migraine treatment. If this is an important mechanism of action in migraine treatment in this population, then other HDAC inhibitors may be even more effective.” – by Amanda Oldt

Reference:

Tietjen G, et al. Exploring the effect of childhood abuse on migraine, depression and anxiety using structural equation modeling. Presented at: American Academy of Neurology Annual Meeting; April 15-21, 2016; Vancouver, British Columbia.

Disclosure: Tietjen owns common stock in Johnson & Johnson and Stryker. Please see the full study for a list of all other authors’ relevant disclosures.