The association between posttraumatic stress disorder and migraine: A systematic review

The aim of this systematic review was to assess the magnitude of the association between posttraumatic stress disorder (PTSD) and migraine by synthesizing prevalence and incidence data from relevant studies.

Migraine is associated with reduced quality of life and an increased risk for psychiatric comorbidities. Recent evidence indicates a growing relevance of PTSD in this context.

A comprehensive literature search was conducted in MEDLINE (via PubMed), EMBASE (via Elsevier), and PsycInfo (via EBSCOhost) from inception to November 22, 2024. Studies were eligible if they included adult populations and reported migraine prevalence or incidence in PTSD and non-PTSD groups. No restrictions were made regarding setting, language, or publication date. Two independent reviewers conducted study selection and data extraction. Results were narratively synthesized, and study quality was assessed using the Joanna Briggs Institute checklists.

Of 12,801 records, 11 studies from five countries were included. Study populations included military personnel, general population, nurses, pregnant women, and students. Migraine prevalence (n = 9) was higher in individuals with PTSD (6.5%-46.5%) compared to those without (1.4%-25.8%), as were incidence estimates (n = 1; 48.5% vs. 39.5%) and incidence rates (n = 1; 5.74 vs. 1.22). All studies reported a positive association between PTSD and migraine, with ratios ranging from 1.2 to 4.7.

This systematic review demonstrates a strong association between PTSD and migraine that extends beyond predisposed populations. These findings highlight the need for systematic trauma assessment in patients with chronic headache disorders. Future research should further explore this bidirectional interaction in population-based samples. PROSPERO study registration: CRD4202461764.