Abstract
The co-existence of psychiatric comorbidities with migraine is well known; however, the relationship between alexithymia and migraine has not been persuasively shown yet. The aim of the study was to assess the relationships between migraine-related disability, depression, anxiety and alexithymia. One hundred and forty-five migraine patients (33.18 ± 8.6; 111 females, 34 males), and 50 control subjects (29.06 ± 7.6; 34 females, 16 males) were prospectively enrolled for the study. The participants completed a demographic data form and Migraine Disability Assessment Scale, Beck Depression Inventory, Beck Anxiety Inventory and Toronto Alexithymia Score-20 (TAS-20). All migraine patients were more depressive (p = 0.01) and anxious (p = 0.001) than the healthy subjects. TAS-20 scores of the migraine sufferers and the control group did not indicate alexithymia. The migraine-related disability of all migraine patients was severe (27.84 ± 29.22). Depression and anxiety scores in the migraine patients were highly correlated with each other and TAS-20 (r = 0.485, p = 0.001) and all its subscales in turn: difficulty in identifying (r = 0.435, p < 0.001) and describing feelings (r = 0.451, p = 0.001) and externally oriented thinking (r = 0.302, p = 0.001). Moreover, logistic regression analysis revealed that depression and anxiety predicted alexithymia. Our findings showed a complex relationship between migraine, depression, anxiety and alexithymia. On the other hand, alexithymia apparently was not directly connected to migraine, but its presence could be predicted in migraine patients because of co-morbid depression and anxiety.
Similar content being viewed by others
References
Taylor GJ (2000) Recent developments in alexithymia theory and research. Can J Psychiatry 45:134–142
Yucel B, Kara K, Ozyalcın S, Ozdemir O, Yucel A (2002) Depression, automatic thoughts, alexithymia, and assertiviness in patients with tension-type headache. Headache 42:194–199
Taylor GJ, Bagby RM, Parker JDA (1997) Disorder of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge University Press, New York
Günther V, Rufer M, Kersting A, Suslow T (2016) Predicting symptoms in major depression after inpatient treatment: the role of alexithymia. Nord J Psychiatry 3:1–7
Buse DC, Silberstein SD, Manack AN, Papapetropoulos S, Lipton RB (2013) Psychiatric comorbidities of episodic and chronic migraine. J Neurol 260:1960–1969
Pesa J, Lage MJ (2004) The medical costs of migraine and comorbid anxiety and depression. Headache 44:562–570
Radat F, Swendson J (2005) Psychiatric comorbidity in migraine: a review. Cephalalgia 25:165–178
Novic A, Kölves K, O’Dywer S, De Leo D (2016) Migraine and suicidal behaviors: a systematic literature review. Clin J Pain 32:351–364
Wise TN, Mann LS, Jani NA, Jani S (1994) Illness beliefs and alexithymia in headache patients. Headache 34:362–365
Muftuoglu HN, Herken H, Demirci H, Virit O, Neyal A (2004) Alexithymic features in migraine patients. Eur Arch Psyhiatry Clin Neurosci. 254:182–186
Yalug I, Selekler M, Erdogan A, Kutlu A, Dundar G, Ankaralı H, Aker T (2010) Correlations between alexithymia and pain severity, depression, and anxiety among patients with chronic and episodic migraine. Psychiatry Clin Neurosci 64:231–238
Gatta M, Canetta E, Zordan M, Spoto A, Ferruzza E, Manco I, Addis A, Dal Zotto L, Toldo I, Sartori S, Battistella PA (2011) Alexithymia in juvenile primary headache sufferers: a pilot study. J Headache Pain 12:71–80
Gatta M, Spitaleri C, Balottin U, Spoto A, Balottin L, Mangano S, Battisella PA (2015) Alexithymic characteristics in pediatric patients with primary headache: a comparison between migraine and tension-type headache. J Headache Pain 16:98
Balottin U, Fusar Poli P, Termine C, Monteni S, Galli F (2013) Psychopathological symptoms in child and adolescent migraine and tension-type headache: a meta-analysis. Cephalalgia 33:112–122
Balaban H, Semiz S, Senturk IA et al (2012) Migraine prevalence, alexithymia, and post-traumatic stress disorder among medical students in Turkey. J Headache Pain 13:259–267
De Andrade Vieira RV, Vieira DC, Gomes WB, Gauer G (2013) Alexithymia and its impact on quality of life in a group of Brazilian women with migraine without aura. J Headache Pain 14:18
Galli F, Caputi M, Sanches G, Vegni E, Bottiroli S, Nappi G, Tassorelli C (2016) Alexithymia in chronic and episodic migraine: a comparative study. J Ment Health. 6:1–5
Bottiroli S, Galli F, Viana M, Sances G, Allena M, Ghiotto N, Guaschino E, Sandrini G, Tassorell, C, Nappi G (2015) Alexithymia and chronic migraine with medication overuse:what relationship? J Headache Pain 16:A 150
Cerruti R, Valastro C, Tarantino S, Valeriani M, Faedda N, Spensieri V, Guidetti V (2016) Alexithymia and psychopathological symptoms in adolescent outpatients and mother suffering from migraines: a case control study. J Headache Pain 17:39
Headache Classification Committee of the International Headache Society (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629–808
Stewart WF, Lipton RB, Dowson AJ, Sawyer J (2001) Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology 56:20–28
Ertas M, Siva A, Dalkara T, Uzuner N, Dora B, Inan L, Idiman F, Sarica Y, Selcuki D, Sirin H, Oguzhanoglu A, Irkec C, Ozmenoglu M, Ozbenli T, Ozturk M, Saip S, Neyal M, Zarifoglu M, Turkish MIDAS group (2004) Validity and reliability of the Turkish Migraine Disability Assessment (MIDAS) questionnaire. Headache 44:786–793
Beck AT, Ward CH, Mendelson M, Mock J, Erbauch J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571
Hisli N (1989) Reliability and validity of Beck depression inventory among university students [in Turkish]. Psikoloji Dergisi 7:3–13
Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897
Ulusoy M, Sahin NH, Erkmen H (1998) Turkish version of the Beck Anxiety Inventory: psychometric properties. J Cogn Psychother Int Q 12:163–172
Bagby RM, Parker JDA, Taylor GJ (1994) The twenty-item Toronto Alexithymia Scale-I:item selection and cross-validation of the factor structure. J Psychosom Res 38:23–32
Sayar K, Güleç H, Ak I. Yirmi soruluk Toronto Aleksitimi Ölçeği’nin Türkçe formunun faktör yapısı, geçerlik ve güvenilirliği. Ulusal Psikiyatri Kongresi Kitabı, 02-06 Ekim 2001, Istanbul, s. 130
Sifneos PE (1973) The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychother Psychosom 22:255–262
Maltilaa AK, Salminenc JK, Nummia T, Joukamaa M (2008) Age is strongly associated with alexithymia in the general population. J Psychosomatic Res. 61:629–635
Kim HW, Rim HD, Kim JH, Lee SJ (2009) Alexithymia and stress response patterns among patients with depressive disorders in Korea. Psychiatry Investigation 6:13–18
Leweke F, Leichsenring F, Kruse J, Hermes S (2012) Is alexithymia associated with specific mental disorders? Psychopathology 25:22–28
Honkalampi K, Tolmunen T, Hintikka J, Rissanen ML, Kylma J, Laukkanen E (2009) The prevalence of alexithymia and its relationship with Youth Self-Report problem scales among Finnish adolescents. Compr Psychiatry 50:263–268
Li S, Zhang B, Guo Y, Zhang J (2015) The association between alexithymia as assessed by the 20-item Toronto Alexithymia Scale and depression: a meta-analysis. Psychiatry Res 22:1–9
Kojima M (2012) Alexithymia as a prognostic risk factor for health problems: a brief of epidemiological studies. Biopsychosocial Med. 6:21
Son SH, Jo H, Rim HD, Kim JH, Kim HW, Bae GY, Lee SJ (2012) A comparative study on alexithymia in depressive, somatoform, anxiety, and psychotic disorders among Koreans. Psychiatry Investigation 9:325–331
Levant RF, Hall RJ, Williams CM, Hasan NT (2009) Gender differences in alexithymia. Psychol Men Masc 10:190–203
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
No disclosures for both authors.
Ethical approval
The study received approval by the Ethics Committee of the Acıbadem University, School of Medicine.
Informed consent
All of the participants gave their informed consent to participate to the study.
Rights and permissions
About this article
Cite this article
Yalınay Dikmen, P., Onur Aysevener, E., Kosak, S. et al. Relationship between MIDAS, depression, anxiety and alexithymia in migraine patients. Acta Neurol Belg 120, 837–844 (2020). https://doi.org/10.1007/s13760-017-0856-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13760-017-0856-x