• physical abuse;
  • child maltreatment;
  • migraine;
  • headache

(Headache 2010;50:761-768)

Objective.— To study the relationship between childhood physical abuse and migraine in adolescents.

Background.— Childhood maltreatment might lead to an increased probability of migraine among adults. Nevertheless, the relationship between migraine and childhood abuse is unknown in adolescents.

Methods.— We enrolled 3955 students, ages 13-15, from 3 middle schools. Each participant completed a valided headache questionnaire for headache diagnosis and the Adolescent Depression Inventory (ADI). A classification of physical maltreatment was given to students who reported they had been beaten by parents or elder family members.

Results.— A total of 926 (23.4%) students were diagnosed with migraine or probable migraine occurring within the 3 months prior to the survey. Physical maltreatment was reported by 945 (23.9%) students, including a frequency of “rarely” in 762 (19.3%) students and “sometimes or often” in 183 (4.6%). The students reporting physical maltreatment were more likely to suffer migraine or probable migraine compared with those who reported no physical maltreatment (30.3% vs 21.3%, odds ratios = 1.6, 95%, CI: 1.4-1.9, P < .001). A higher frequency of physical maltreatment was associated with a higher likelihood of migraine diagnosis (21.3% vs 28.3%, vs 38.3%, “never” vs “rarely” vs “sometimes or often maltreated,” respectively, P < .001). In addition, among the students diagnosed with migraine, those reporting physical maltreatment had higher mean ADI scores, a higher frequency of headaches, and a greater proportion of severe headaches.

Conclusions.— The results suggest that physical maltreatment is associated with migraine in adolescents and that physical maltreatment may be related to an increase in the frequency and intensity of headaches in adolescents with migraines. A history of physical maltreatment may be helpful in the treatment of adolescents suffering from migraine.