Mapping Review on Characteristics of Publications on Modifiable Psychosocial Factors in Headache Diseases

Modifiable psychosocial risk factors are associated with and may contribute to the chronification of headache diseases. Assessing such factors is an integral part of multidimensional pain management. However, an overview of modifiable psychosocial risk factors and their role (e.g., chronification, prevalence, association, comorbidity) in migraine (MGR), tension-type headache (TTH), and cervicogenic headache (CeH) is missing. The present mapping review aimed to provide an overview of characteristics of modifiable psychosocial risk factors in MGR, TTH, and CeH.

A total of 522 studies were included, mostly focussing on MGR (n = 681) followed by TTH (n = 95). A disproportionate focus on psychological rather than social factors (n = 28) was observed across studies. Emphasis was on associations with headache (n = 181), comorbidities (n = 102), and prevalence of psychosocial factors in people with headache (n = 63). Cross-sectional designs dominated (64%). Research was concentrated in North America (n = 182), Europe (n = 201), and Asia (n = 90). Generalization was limited by study heterogeneity. Most research focussed on comorbidities, associations, and prevalence of modifiable psychosocial risk factors in MGR and to a lesser extent TTH. Studies were mainly conducted in Europe and North America. Key gaps were identified, including (1) insufficient investigation of psychosocial factors in TTH and CeH, (2) a narrow focus on psychological factors in MGR, (3) underrepresentation of research from the African continent, and (4) a scarcity of longitudinal designs to elucidate the role of psychosocial factors in headache chronification. Addressing these gaps is essential within a multidimensional framework for MGR, TTH, and CeH.