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Saturday, June 30, 2018

Migraines Strain Family Ties


Migraine headaches can have a variety of detrimental effects on family life, researchers reported here.
Results from the CaMEO study showed that having chronic migraine influences decisions about when to get married and whether to have children. Another study found that a parents migraines have an impact on children’s well-being and parent-child relationships.
The studies were presented at the American Headache Society (AHS) annual meeting.
“Both studies illustrate the fact that migraine is a pervasive disease — it doesn’t just affect the person suffering from migraine, but also their families. I think it also illustrates a bigger societal problem that we have about stigma and the need to educate the general public about what migraine is and the impact it has on so many people,” AHS session moderator Rashmi Halker, MD, of the Mayo Clinic in Phoenix told MedPage Today.
CaMEO Findings
Dawn Buse, PhD, of Albert Einstein College of Medicine in New York City presented results from a substudy of CaMEO (Chronic Migraine Epidemiology and Outcomes), an ongoing longitudinal web-based survey that has collected data on symptoms, treatment, and quality of life from thousands of people with migraines in the U.S.
“We all work with patients with migraines and we know what a big impact this can have on so many important areas of their lives, but we wanted to quantify it in a systematic way,” Buse said.
Of the nearly 20,000 migraine patients who met the study criteria and were invited to complete the Family Burden Module (FBM) of the survey, a total of 13,064 were included in the sample: 11,938 with episodic migraines and 1,126 with chronic migraine.
Participants were classified according to whether they were not currently in a relationship, in a relationship but not living together, or in a relationship and living with their partner. They were asked how headaches affected their current or past relationships. Those with children living at home were asked how headaches affect their parenting and other aspects of family life.
Of the 3,512 respondents not in a current relationship, 16.8% said their headaches had been a problem in previous relationships, including contributing to a relationship ending. This was the case for 37.0% of people with chronic migraine and 15.0% of those with episodic migraines. Results were similar for men and women.
Among the 1,395 people who were in a relationship but not living together, 17.8% said their headaches had caused problems, including preventing them from developing a closer relationship such as moving in together or getting married. Again, this was more likely for people with chronic migraine (43.9%) than for those with episodic migraines (15.8%).
Among the 8,157 respondents in a current live-in relationship, 49.0% said they thought they would be a better partner if they did not have headaches; 78.2% of those with chronic migraine and 46.2% of those with episodic headaches thought this would be the case.
“On perhaps the most heartbreaking question, 10% of people with chronic migraine had made different choices about having children because of their headaches,” Buse reported.
On this subject, 9.6% of chronic migraineurs and 2.6% of those with episodic migraines said they had delayed having children or had fewer children due to their headaches. Among those who did have kids, 64.8% and 35.7%, respectively, said they would be a better parent if they did not have migraines. Respondents said their headaches interfered with things like participating in social events with their children or helping them with homework.
Buse recommended that providers should consider the overall burden of disease when managing patients with migraine, especially those with chronic headaches. She suggested that personalized treatment plans could include behavioral interventions for the patient, the couple, and other family members as appropriate.
Impact on Kids
Elizabeth Seng, PhD, also of Albert Einstein College of Medicine, presented findings from a study of the impact of a parent’s migraine on their children.
This analysis included 40 pairs consisting of a parent who experienced migraine and a child, ages 11-17 years, living at home. The families were predominantly white, well-educated, and relatively affluent. Parents and children were required to have separate email addresses and the parents were encouraged to let their children complete the survey without interference.
All but one of the parents were mothers and most were married. They had a median of 6.8 headaches per month, with an average severity of 6.8, and two-thirds reported severe disability on the MIDAS (Migraine Disability Assessment) questionnaire. The children had an average age of 13.6 years and boys and girls were about equally represented; 60% of the children reported having headache attacks themselves.
Parents and children both reported that the parents’ migraine had a moderate impact, with the strongest effects seen on the child’s overall well-being and parent-child relationships, followed by the burden of providing daily help and emotional impact. More than 60% of the children said they would like more training to teach them how to better care for their parent with migraine.
However, in some cases the parent-child pairs did not show much agreement, Seng noted. Although a majority of the parents thought their children could benefit from support groups or speaking with someone in a similar situation, only a quarter of the children agreed. Likewise, only 27% of the children though it would be helpful to speak with a professional counselor. “The kids said ‘This doesn’t sound so great,'” Seng reported.
“Half of the children also had migraine, and that was not something we selected for,” Send told MedPage Today. “There are lifestyle factors that are important for managing migraine, like managing stress, getting to sleep at the same time every night, not skipping meals. These are healthy for all of us, but are particularly important for people with migraine. If we can get families to decide that ‘We’re gong to eat small healthy meals together, that we’re going to go to bed at the same time,’ that’s only going to help everyone’s health.”
The CaMEO study was sponsored by Allergan.
Buse disclosed support from and relevant relationships with Allergan, Avanir, Eli Lilly, and Promius.
Seng disclosed relevant relationships with GlaxoSmithKline and Eli Lilly.

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