Migraine and work - beyond absenteeism: Migraine severity and occupational burnout - A cohort study

Migraine, a condition affecting 12% of the population, is a prevalent cause of disability, significantly impacts individuals during their most productive working years. Several studies have established that a migraine patient's job performance is often limited by absenteeism and presenteeism. The present study aimed to investigate the impact of migraines on occupational burnout, which affects up to 40% of workers.

A subset of participants from the Negev Migraine Cohort, including both migraine patients and non-migraine controls, were asked to complete the study questionnaire. The main exposures of interest were migraine diagnosis and severity. The primary outcome was occupational burnout. Migraine severity and associated disability were evaluated using the Migraine Disability Assessment (MIDAS) score, psychiatric comorbidities using the Depression, Anxiety and Stress Scale - 21 Items (DASS-21) scale and occupational burnout using the Maslach Burnout Inventory (MBI-GS version) scale. Statistical analyses included multivariable quantile regression models to identify associations and adjust for potential confounders.

In total, 675 migraine patients and 232 non-migraine participants participated in the study. Migraine patients exhibited higher rates of depression (mean DASS-21: 0.864 vs. 0.664, standardized mean difference (SMD) = 0.262), tended to work longer hours (median weekly hours: 40.0 vs. 36.0, SMD = 0.148) and expressed a preference for remote work (20.3% vs. 10.3%, SMD = 0.097). Migraine patients reported significantly higher levels of occupational burnout (mean burnout score: 3.46 vs. 2.82, SMD = 0.469). Controlling for depression, anxiety and stress, migraine diagnosis (25th percentile estimate = 0.67, p = 0.002, 75th percentile estimate = 0.92, p = 0.032) and migraine severity (estimates: 2.2-5.3, p < 0.001 for all) were associated with higher levels of occupational burnout.

Migraine diagnosis and severity is associated with an occupational burnout, after controlling for various psychological and work-related factors. The findings underscore the need for workplace adjustments to support migraine patients' participation in the work market.