A Retrospective, Comparative Study on the Frequency of Abuse in Migraine and Chronic Daily Headache


  • B. Lee Peterlin DO,

  • Thomas Ward MD,

  • Jeffrey Lidicker MSc,

  • Morris Levin MD

  • From the Department of Neurology, Drexel University College of Medicine, Philadelphia, PA (Dr. Lee Peterlin); Department of Neurology, Dartmouth Hitchcock Medical Center, Lebanon, NH (Drs. Ward and Levin); and Temple University, Center for Statistical and Information Science, Philadelphia, PA (Dr. Lidicker).

Address all correspondence to Dr. B. Lee Peterlin, Neurology, Drexel University College of Medicine, Philadelphia, PA.


Objective.—To assess and contrast the relative frequency of a past history of physical and/or sexual abuse in patients with chronic daily headache (CDH) versus migraine.

Background.—A number of risk factors have been identified as risk factors for chronification of headache disorders. Limited data exist regarding the influence of physical and/or sexual abuse on primary headache disorders.

Methods.—This was a retrospective chart review of 183 consecutive new headache patients seen from December 2004 through August 2005 at an outpatient tertiary-care center. Patients were included in the study if they had chronic daily headache (with criteria for medication over-use headache or chronic migraine), or migraine with or without aura. A history of physical and/or sexual abuse was systematically asked of all headache patients at their first visit in the clinic. This information was then transferred to a semi-standardized form and the relative frequency of abuse in both groups contrasted.

Results.—Of the 161 patients included in the study, 90.1% were female with a mean age of 36.4 ± 12.0. A total of 59.0% of the patients were diagnosed with CDH and 41.0% were diagnosed with migraine. Overall, 34.8% of all patients, 40.0% of CDH patients, and 27.3% of migraine patients had a history of physical and/or sexual abuse. The relative frequency of a history of physical and/or sexual abuse was higher in the CDH group as compared to the migraine group (P= .048).

Conclusion.—The relative frequency of abuse is higher in CDH sufferers than migraineurs, suggesting that physical and sexual abuse may be risk factors for chronification.