Parental Stress Levels Linked With Pediatric Migraine Severity

Researchers in Italy found parental stress levels are correlated with the severity of their child's migraine condition.

New study results published in Pediatric Reports underscore the need for consideration of the holistic contribution of the family in the clinical management of pediatric migraines. In particular, findings showed children’s headache-associated disability was strongly linked with parents’ total stress levels.

It is estimated around 9% of children experience migraine, while it is the most common cephalic pain reported in the developmental age, researchers explained. “In general, parents of children with chronic medical, neurological or psychiatric conditions show elevations of perceived stress levels and a reduction of parental quality, and specifically, children with headaches seem to be at a high risk for psychological maladjustment, including internalizing disorders,” they added.

To better understand the relationship between maternal stress and migraine without aura (MwoA) in children and its putative correlation with migraine intensity, frequency and disability severity, investigators conducted a questionnaire-based study in Italy.

A total of 474 mothers from a mid-level socioeconomic status were included in the study. Of these, 237 had children with MwoA (120 boys, 117 girls) while the remaining mothers had children without migraine (122 males, 115 females). All participants were recruited from the same geographic region and all children participants were between the ages 6 and 12. The 2 groups also did not differ in education level.

Parents completed the Parent Stress Index-Short Form (PSI-SF) for the assessment of parental stress, and children with MwoA completed the Pediatric Migraine Disability Assessment (PedMIDAS) to assess the presence of related disability.

Overall, “the results showed a significantly higher rate of stress in mothers of MwoA children (P < .001) in all the domains explored by the PSI-SF and a statistically significant correlation between the maternal stress total score and the intensity and frequency of migraine attacks (P < .0001),” authors wrote.

Specifically, analyses revealed positive and significant correlations between maternal stress levels and the intensity (r = 0.40; P <.0001) and frequency (r = 0.54, P < .0001), but not duration (r = 0.07; P =0.253), of MwoA attacks, they said.

Previous studies have yielded mixed results when it comes to evaluating stress among parents of children with migraine. However, past studies did not evaluate the possible correlation with the attacks’ intensity and frequency or disability degree, researchers noted.

Furthermore, it is possible that any chronic disease among children may alter the parental quality itself and lead to feelings of guilt among the parents. In addition, maternal stress could increase the stress of a child and affect migraine severity.

Lack of data on the stress levels of fathers marks a limitation to the analysis; however, published literature indicated mothers are more vulnerable to stress than fathers.

“Children with MwoA may be more likely to benefit from behavioral interventions to improve stress assessment and coping strategies for treatment,” researchers concluded.


Smirni D, and Carotenuto M. Pediatric chronic migraine severity and maternal stress. Pediatr Rep. Published online October 15, 2021. doi:10.3390/pediatric13040068