Role of Psychological Factors in Migraine

Migraine, marked by moderate to severe headaches, is frequently accompanied by reversible neurological symptoms. Recent studies have revealed a complex and significant relationship between psychological factors and the onset and progression of migraine. Personality traits, such as neuroticism and harm avoidance, play a crucial role in the development, progression, and treatment outcomes of migraines. Migraine patients often experience comorbid mental health conditions, such as depression and anxiety, which contribute to a diminished quality of life by exacerbating migraine-related disability and impaired occupational functioning. In particular, high levels of pain catastrophizing and anxiety sensitivity in migraine sufferers reflect their negative cognitive beliefs, which are closely linked to both their personality traits and vulnerability to mental disorders. This article explores the pathophysiological mechanisms underlying the relationship between migraine and psychological factors, including genetic influences, overlapping brain regions, 5-hydroxytryptamine (5-HT) dysfunction, and neurogenic inflammation. While traditional pharmacological treatments for migraine are often influenced by psychological factors and may have limited efficacy, psychotherapy, such as cognitive behavioral therapy and positive thinking therapy, has been increasingly recognized for its role in alleviating the psychological symptoms associated with migraine and enhancing overall therapeutic outcomes.