Stress, Anxiety, Depression, and Pain Catastrophizing in Migraine: Associations with Disability and Quality of Life

Migraine is a chronic neurological condition that significantly impairs daily functioning and quality of life. This study investigated how psychological factors, including anxiety, depression, perceived stress, and pain catastrophizing, influence migraine symptom severity and quality of life among 128 patients attending outpatient clinics in SADAT City, Egypt. Participants completed validated Arabic versions of the Migraine Disability Assessment, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Migraine-Specific Quality of Life Questionnaire, and Perceived Stress Scale. Findings revealed high levels of psychological distress, with over two-thirds of participants reporting elevated anxiety and depression symptoms. Correlation and regression analyses demonstrated that depression and perceived stress were strong predictors of migraine severity and diminished quality of life, while anxiety and catastrophizing also contributed significantly. Female participants exhibited higher anxiety symptoms, depressive symptoms, and catastrophizing levels compared to males. These results highlight the central role of psychological distress in exacerbating migraine burden and reducing overall well-being. The findings emphasize the necessity of integrating psychological assessment and interventions, such as cognitive-behavioral therapy and stress management, into migraine treatment plans. This study contributes to the literature by simultaneously examining multiple psychological predictors of migraine disability and migraine-specific quality of life within an underrepresented clinical population in Egypt, providing further evidence for the biopsychosocial understanding of migraine. Addressing emotional and cognitive factors may enhance clinical outcomes and improve patients' functional and emotional quality of life.