Nicole Rosendale1,2, Elan L Guterman3,2, Juno Obedin-Maliver4,5,6, Annesa Flentje7,8, Matthew R Capriotti9, Micah E Lubensky5,7, Mitchell R Lunn5,6,10. 1. Department of Neurology, School of Medicine, University of California San Francisco, San Francisco, CA nicole.rosendale@ucsf.edu. 2. Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA. 3. Department of Neurology, School of Medicine, University of California San Francisco, San Francisco, CA. 4. Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA. 5. The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA. 6. Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA. 7. Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA. 8. Alliance Health Project, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA. 9. Department of Psychology, San Jose State University, San Jose, CA. 10. Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
Abstract
OBJECTIVE: This study sought to describe migrainous headache frequency and severity and to examine the relationship between trauma, discrimination, and migraine-associated disability in a sample of sexual and/or gender minority (SGM) adults. METHODS: We performed a cross-sectional study of SGM people in The Population Research in Identity and Disparities for Equality (PRIDE) Study from August-October 2018. The primary exposure was any trauma or discrimination, regardless of attribution. The primary outcome was moderate-severe migraine disability, as defined by a Migraine Disability Assessment (MIDAS) Questionnaire score ≥11. We performed descriptive analysis comparing respondents with any migrainous headache to those without. Multivariable logistic regression examined the association between trauma/discrimination and migraine disability, controlling first for sociodemographic and clinical factors and then for psychiatric comorbidities. RESULTS: Of the 3,325 total respondents, 1,126 (33.9%) screened positive for migrainous headache by ID-Migraine criteria. Most people with migraine self-reported moderate (n=768, 68.2%) or severe (n=253, 22.5%) intensity. The median MIDAS score was 11 (interquartile range [IQR] 5-25). Most respondents with migraine (n=1055, 93.7%) reported a history of trauma or discrimination. In unadjusted analysis, exposure to both trauma and discrimination was associated with higher odds of moderate-severe disability (OR 1.76, 95% CI 1.34-2.32). After adjustment for self-reported psychiatric comorbidities of anxiety, depression, and post-traumatic stress disorder, this association lost statistical significance. CONCLUSION: Migrainous headache is common among our sample of SGM adults, and prior experiences with trauma and discrimination is associated with increased migraine disability. Our findings suggest that psychiatric comorbidities play a significant role in this relationship, identifying a potentially modifiable risk factor for disability in SGM people with migraine.
OBJECTIVE: This study sought to describe migrainous headache frequency and severity and to examine the relationship between trauma, discrimination, and migraine-associated disability in a sample of sexual and/or gender minority (SGM) adults. METHODS: We performed a cross-sectional study of SGM people in The Population Research in Identity and Disparities for Equality (PRIDE) Study from August-October 2018. The primary exposure was any trauma or discrimination, regardless of attribution. The primary outcome was moderate-severe migraine disability, as defined by a Migraine Disability Assessment (MIDAS) Questionnaire score ≥11. We performed descriptive analysis comparing respondents with any migrainous headache to those without. Multivariable logistic regression examined the association between trauma/discrimination and migraine disability, controlling first for sociodemographic and clinical factors and then for psychiatric comorbidities. RESULTS: Of the 3,325 total respondents, 1,126 (33.9%) screened positive for migrainous headache by ID-Migraine criteria. Most people with migraine self-reported moderate (n=768, 68.2%) or severe (n=253, 22.5%) intensity. The median MIDAS score was 11 (interquartile range [IQR] 5-25). Most respondents with migraine (n=1055, 93.7%) reported a history of trauma or discrimination. In unadjusted analysis, exposure to both trauma and discrimination was associated with higher odds of moderate-severe disability (OR 1.76, 95% CI 1.34-2.32). After adjustment for self-reported psychiatric comorbidities of anxiety, depression, and post-traumatic stress disorder, this association lost statistical significance. CONCLUSION: Migrainous headache is common among our sample of SGM adults, and prior experiences with trauma and discrimination is associated with increased migraine disability. Our findings suggest that psychiatric comorbidities play a significant role in this relationship, identifying a potentially modifiable risk factor for disability in SGM people with migraine.
Authors: Michael J McDermott; Joshua C Fulwiler; Todd A Smitherman; Kim L Gratz; Kevin M Connolly; Matthew T Tull Journal: J Behav Med Date: 2015-11-26
Authors: Mitchell R Lunn; Micah Lubensky; Carolyn Hunt; Annesa Flentje; Matthew R Capriotti; Chollada Sooksaman; Todd Harnett; Del Currie; Chris Neal; Juno Obedin-Maliver Journal: J Am Med Inform Assoc Date: 2019-08-01 Impact factor: 4.497
Authors: Karen I Fredriksen-Goldsen; Charles A Emlet; Hyun-Jun Kim; Anna Muraco; Elena A Erosheva; Jayn Goldsen; Charles P Hoy-Ellis Journal: Gerontologist Date: 2012-10-03
Authors: R B Lipton; D Dodick; R Sadovsky; K Kolodner; J Endicott; J Hettiarachchi; W Harrison Journal: Neurology Date: 2003-08-12 Impact factor: 9.910
Authors: Madeline B Deutsch; Jamison Green; JoAnne Keatley; Gal Mayer; Jennifer Hastings; Alexandra M Hall Journal: J Am Med Inform Assoc Date: 2013-04-30 Impact factor: 4.497