Pain catastrophizing and medication overuse in patients with chronic migraine

INTRODUCTION: Migraine is a frequent and debilitating primary headache. Pain catastrophizing is a negative set activated in response to anticipated or actual pain. The anticipatory fear of pain, one of its characteristics, has been associated with a greater prescription and use of analgesics. AIM: To explore the pain catastrophizing in relation to analgesic overuse and the headache impact on quality of life in patients with chronic migraine. PATIENTS AND METHODS: An observational cross-sectional analytical study was performed. Patients older than 18 years with chronic migraine were included, who were given anonymously the Pain Catastrophizing Scale and the Head Impact Test-6. RESULTS: When comparing the incidence of analgesic overuse among patients with clinical pain catastrophizing levels and those without pain catastrophizing, the probability of analgesic overuse was 16 times higher in the first group (odds ratio = 16.06; 95% CI = 5.91-43.61; p < 0.0001). When comparing the presence of a severe migraine impact in patients with and without pain catastrophizing, the probability of a severe migraine impact is approximately eight times greater in the first group (odds ratio = 8.27; 95% CI = 3.19-21.42; p < 0.0001). CONCLUSION: Clinical levels of pain catastrophizing in patients with chronic migraine might be associated with a higher incidence of analgesic overuse and a greater headache impact on quality of life.