The status and high risk factors of severe psychological distress in migraine patients during nCOV-2019 outbreak in Southwest China: a cross-sectional study

DOI: https://doi.org/10.1186/s10194- 020- 01168- 5

Abstract-Summary Psychological distress is highly prevalent among migraineurs during public health emergencies.

The emotion status of migraineurs stayed unclear during the nCOV-2019

outbreak.

To understand psychological distress of migraineurs by comparing with common population and identify potential high-risk factors of severe psychological distress among migraine patients.

Data on clinicodemographics and psychological distress in the month of February

2020 (during in the nCOV-2019 outbreak in China) were collected.

Potential risk factors of severe psychological distress were identified using uni-

variate and multivariate logistic regression.

Migraineurs showed significantly higher K-6 scores than controls (P < 0.001). During public health outbreaks, healthcare professionals should focus not only on controlling and reducing migraine attack but also on mental health of migraineurs, especially those with high frequency migraine attack.

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COVID-19 and SARS-COV2 Vaccines

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Extended: The emotion status of migraineurs stayed unclear when facing public

health emergency.

Background The outbreak of nCOV-2019 has spread around the whole world and defined as a major public health emergency [296, 297].

Anxiety and panic in the public can be created by the flood of disaster-related information, and the mental health of populations can be affected, even threatened by these circumstances, based on World Health Organization assessment [298].

While anxiety and panic may increase migraine attack, then serious headache

may increase psychiatric disorder in migraineurs [299, 300].

The present study compared the severity of psychological distress between migraineurs and common population during the nCOV-2019 outbreak in southwest China by using Kessler 6-item psychological distress scale and a custom-designed questionnaire.

It also explored risk factors for severe psychological distress among migraineurs, which showed the frequency of migraine attacks and attention paid to media cover- age of the nCOV-2019 outbreak might cause severe psychological distress in migraineurs.

Method The healthy controls had no history of migraine or other types of headache, psychi- atric disorders, and alcohol or drug abuse and did not take any other drugs regularly for 3 months at least also.

The questionnaire for this study included the demographics information about sex, age, marriage status, education level; clinical data about migraine information (attack frequency), medical history (including mental illness history, and treatment history) from electronic clinical records in the West China Hospital outpatient department; and epidemiological contact information about their level of concern over the COVID-19 outbreak (on a 4-point scale from “relatively unconcerned or very unconcerned” to “very concerned”), and the time they spent each day receiving information about the outbreak.

Severe psychological distress was defined as a total score >12 [289]. Multivariate logistic regression was used to explore factors independently asso-

ciated with severe psychological distress in patients with migraine.

Results Patients and healthy controls showed no significant differences in sex, age, marriage status, education level, history of epidemiological contact, suspected COVID-19 cases, COVID-19 cases in respondent’s residential community and feeling difficulty to control emotion during the nCOV-2019 outbreak.

Besides, migraine patients reported significantly greater concern about the out- break (P < 0.001) and more time paying attention to outbreak (P < 0.001) and higher frequency of dreaming about nCOV-2019 (P = 0.019) than healthy controls.

Compared with healthy controls, patients with migraine had significantly higher K-6 scores than healthy controls (P < 0.001), including for the items about feeling

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“nervous”, “hopeless”, “restless or fidgety”, “so depressed that nothing could cheer you up”, and “everything is an effort”.

Discussion After further explore risk factors related to severe psychological distress in migraineurs during nCOV-2019 outbreak, we found the frequency of migraine attacks and attention paid to media coverage of the nCOV-2019 outbreak is the two high risk factors for psychological distress in migraineurs.

We found the amount of time spent daily on media coverage of the nCOV-2019 outbreak were associated with severe psychological distress among migraineurs during the nCOV-2019 outbreak.

We also found that migraine attack frequency in previous 30 days was associated with severe psychological distress among migraineurs during the nCOV-2019 outbreak.

Combine with these two factors, this result indicated that during public health emergency, migraineurs should take measures or at least pay more attention to con- trol or reduce migraine attack and should focus on only the necessary media infor- mation about the outbreak in order to avoid severe psychological distress.

Conclusions During public health outbreaks, healthcare professionals should focus not only on controlling migraine attack but also on mental health of migraineurs, especially those with high frequency migraine attack.

They should advise migraineurs to avoid paying too much attention on media

coverage of the outbreak.

Acknowledgement A machine generated summary based on the work of Ma, Mengmeng; Fang, Jinghuan; Li, Changling; Bao, Jiajia; Zhang, Yang; Chen, Ning; Guo, Jian; He, Li 2020 in The Journal of Headache and Pain.

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