Irritability and its relationships with psychological symptoms in adolescents with migraine: a case-control study

The aim of this study was to investigate self- and parent-reported irritability in adolescents with migraine and to evaluate the relationship between self- and parent-reported irritability and psychological symptoms in adolescents with migraine.

The sample of this single-center cross-sectional case-control study consisted of 71 adolescents with migraine (who were followed in a pediatric neurology clinic) and their parents. The control group consisted of 41 age- and sex-matched healthy adolescents and their parents.

It was observed that there were significant differences in both self- (p < 0.001) and parent-reported (p < 0.001) irritability scores between the migraine and control groups. When the two groups were compared in terms of psychological symptoms, adolescents with migraine had significantly higher levels of anxiety (p < 0.001) and emotional problems (p < 0.001) than their healthy peers. This significant difference persisted even after controlling for confounding factors such as age, gender, family income, and maternal and paternal educational level. Our results revealed a moderate positive correlation between irritability scores and anxiety scores (r = 0.522, p < 0.001) and between irritability scores and emotional/behavioral problem scores (r = 0.487, p < 0.001) in the migraine group. In addition to these results, the odds ratios of self-reported irritability scores and emotional problem scores for migraine were 1.31 and 1.41, respectively.

The levels of anxiety, emotional/behavioral, and attention deficit/hyperactivity problems increased as the levels of irritability increased in the migraine group, suggesting that the psychosocial functionality of these adolescents may be impaired. Therefore, all adolescents with migraine (especially those with irritability) may have need of psychosocial support.