Researchers say adults who have been emotionally abused as a child are more likely to experience migraine than tension headache.
The research team - including Dawn C. Buse, PhD, director of behavior at the Montefiore Headache Center and associate professor of clinical neurology at the Albert Einstein College of Medicine, both in New York - publish their findings in the journal Neurology.
Each year, more than 6 million children in the US are the victims of physical, emotional or sexual abuse. A report of child abuse is made every 10 seconds.
Past studies have indicated that abused children are likely to experience frequent headache. But the researchers note that such studies have not investigated this association by headache subtype.
"Other pioneering studies support the association but are limited by the nature of their samples (i.e. subspecialty headache centers), incomplete characterization of headache subtypes or limited assessment of adverse childhood experiences," note the authors.
In their study, Buse and colleagues wanted to test the idea that adults who are abused during childhood are more likely to experience migraine than less severe episodic tension-type headache.
The researchers assessed data from 9,734 adults who were part of the American Migraine Prevalence and Prevention Study. Of these, 8,305 adults experienced migraine and 1,429 experienced tension headache.
In 2007, participants were required to complete the Childhood Trauma Questionnaire, which disclosed their history of three types of childhood maltreatment: emotional abuse (intentionally doing or saying things to harm a child), emotional neglect (failing to do things that promote a child's emotional well-being, either intentionally or unintentionally) and sexual abuse.
Emotional abuse linked to 33% higher risk of migraine than tension headache
The team found that 24.5% of participants with migraine had suffered emotional abuse during childhood, while 21.5% of those with tension headache had experienced such abuse.
Overall, subjects who experienced emotional abuse before the age of 18 were 33% more likely to have migraine than tension headache as an adult. This finding remained even after the researchers accounted for participants' age, sex, race, depression and anxiety, and household income.
Furthermore, the team found that subjects who experienced two forms of abuse during childhood were 50% more likely to have migraine in adulthood than those who experienced one form of abuse.
Although researchers found an increased risk of migraine in adulthood among participants who had experienced emotional neglect or sexual abuse as a child, these subjects were at no higher risk once depression and anxiety were taken into account.
Commenting on the findings, Buse says:
"Childhood maltreatment can have long-lasting effects like associated medical and psychological conditions, including migraine, in adulthood. When managing patients with migraine, neurologists should take childhood maltreatment into consideration."
In an accompanying editorial, B. Lee Peterlin, of the Department of Neurology at Johns Hopkins University Medical Center in Baltimore, MD, says the findings from Buse and colleagues are an "important contribution to advancing our understanding of the association between adverse childhood experiences and headache disorders."
"In particular," she adds, "it highlights the importance of identification of adverse childhood experiences in both migraine and tension-type-headache participants as this can help guide treatment strategies and future research."
In June 2014, Medical News Today reported on a study published in the American Journal of Psychiatry claiming child abuse "has serious consequences for brain development."