Migraine with comorbid fibromyalgia: psychological burden and impact on frequency and severity of migraine attacks

There is growing evidence suggesting a bidirectional relationship between fibromyalgia and migraine. The aim of this work was to study the impact of fibromyalgia on the frequency and severity of migraine headache attacks and the psychological burden in patients with comorbid migraine and fibromyalgia.

This cross-sectional comparative study was conducted on 114 patients with comorbid migraine and fibromyalgia and 270 patients with migraine only. All included patients were subjected to a comprehensive assessment of headache through face-to-face interview and assessment of the psychological state using the Depression, Anxiety and Stress Scale-12 (DASS-12). Patients with fibromyalgia were requested to answer the Revised Fibromyalgia Impact Questionnaire (FIQR).

Patients with comorbid migraine and fibromyalgia had significantly higher monthly migraine days (MMD), headache impact test-6 (HIT-6), and DASS-12 total scores than patients with migraine only (p-value < 0.001, 0.009, and < 0.001, respectively). There was a statistically significant positive correlation between the FIQR total score and DASS-12 total score (p-values = 0.001). Additionally, statistically significant positive correlations were found between the FIQR total score and both the MMD and HIT-6 total scores (p-values = 0.002 and 0.008, respectively). There were also statistically significant positive correlations between the DASS-12 total score and both the MMD and HIT-6 total scores (p-values = 0.006, 0.027, respectively).

Fibromyalgia is an aggravating comorbid condition with migraine that is associated with a higher frequency and severity of migraine headache attacks, in addition to increasing the psychological burden.