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Comparing Psychological Difficulties Among Migraineurs and Patients With Epilepsy


Compared with patients with epilepsy, migraineurs tend to suffer more from psychological difficulties, according to a study published in Journal of Multidisciplinary Healthcare.

Compared with patients with epilepsy, migraineurs tend to suffer more from psychological difficulties, according to a study published in Journal of Multidisciplinary Healthcare.

Migraine is the second leading cause of “years lost due to disability” worldwide and affects roughly 10% to 18% of the population, imposing significant costs to both patients and health systems.

Although migraine is categorized by a severe headache and sometimes aura, epilepsy manifests as unprovoked seizures and can cause psychological and psychiatric complications. Epilepsy is also considered to be associated with migraine and with other somatic disorders such as cardiovascular diseases and diabetes.

“It is important to assess the impact of brain disorders on the patient’s life to help physicians better determine treatment outcomes and monitor the disease course, although there is no exact method to be used for this purpose,” the authors wrote.

To compare psychological difficulties among individuals with prevalent disabling conditions, the researchers conducted a cross-sectional study where 240 migraineurs and 210 individuals with epilepsy completed the Psychosocial Factors Relevant to Brain Disorders in Europe (PARADISE-24) questionnaire.

All participants were recruited from the Isfahan Neurosciences Research Center in Iran between January and April 2020 and were over the age of 18. Questions included in PARADISE-24 are answered on a 3-point scale (none = 0, some = 1, a lot = 2), with high scores indicating greater psychosocial difficulties due to brain disorders. Demographic data in addition to disease characteristics (severity of headache, frequency of seizures, etc) were also collected.

Analyses revealed:

  • In migraineurs, the mean (SD) age and mean headache severity (by means of visual analogue scale [VAS]) were 38.6 (11.6) years and 6.8 (2.8), respectively
  • In patients with epilepsy, the mean age and mean duration of the disease were 33.6 (13.4) and 12 (10.3) years, respectively
  • The mean PARADISE score was significantly higher in migraineurs than in epileptic cases: 57.9 (12) vs 50.7 (15.1) (P <.001)
  • Among patients with epilepsy, the mean score was significantly different between patients whose seizures were under control and those whose seizures were not: 49.8 (15.9) vs 65.4 (9.1) (P <.001)
  • There was no significant difference between migraineurs regarding sex and the number of days with headache

“Patients with migraine suffer from a wide range of psychological difficulties such as depression, poor sleep, sexual dysfunction, anxiety, and impaired quality of life, each of which requires a specific questionnaire or instrument to be assessed,” the researchers wrote. One advantage of the PARADISE questionnaire is its ability to assess various psychological aspects at once.

Epilepsy is also associated with psychological problems like depression, anxiety, memory disfunction, and stigma. The disease accounts for the highest age-standardized disability-adjusted life years (DALYs) in both sexes (0.7% of total DALYs).

Because the study was conducted in a single center and did not include quality of life measurements, the researchers recommended that multicentric studies, including an evaluation of other aspects of both diseases, be carried out.

The findings could guide physicians to consider psychological well-being in migraineurs, the authors concluded.


Mirmosayyeb O, Shaygannejad V, Ghajarzadeh M. Comparison of psychological difficulties in patients with migraine and epilepsy using PARADISE-24 questionnaire. J Multidiscip Healthc. Published online July 10, 2020. doi:10.2147/JMDH.S260056

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