Department of Psychiatry, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
J Womens Health (Larchmt). 2013 Oct;22(10):871-6. doi: 10.1089/jwh.2013.4279. Epub 2013 Aug 9.
Both female reproductive hormones and childhood sexual abuse (CSA) are implicated in migraine and in menstrually related mood disorders (MRMD). We examined the association of migraine, including migraine with aura (MA), and history of MRMD or CSA.
A total of 174 women (mean age 33.9 ± 7.6 years) in this cross-sectional study were evaluated for (1) current MRMD using prospective daily ratings; (2) history of CSA using structured interview; and (3) MA and migraine without aura using the International Classification of Headaches Disorders II criteria.
Ninety-six women met MRMD criteria (21 of whom had history of CSA) and 78 women were non-MRMD controls (16 with CSA histories). Migraine with aura was more prevalent in women with MRMD when compared to non-MRMD controls (11/88 and 0/86, respectively, p=0.001). In MRMD women only, a CSA history was associated with higher MA rates (6/21 and 5/67, respectively, p=0.019). A combination of current MRMD diagnosis and a history CSA was associated with increased risk for MA, even after adjusting for potential confounders (odds ratio=12.08, 95% confidence interval 2.98-48.90, p<0.001).
Women with MRMD may be vulnerable to the development of MA, and a history of CSA in women with a MRMD appears to increase that vulnerability. MRMDs and MA should be included among other poor mental and physical health outcomes of an abuse history. Routine screening for abuse histories would potentially improve identification of women with increased risk of experiencing abuse-related disorders.
女性生殖激素和儿童期性虐待（CSA）都与偏头痛和与月经相关的情绪障碍（MRMD）有关。我们研究了偏头痛（包括有先兆偏头痛[MA]）和 MRMD 或 CSA 病史的关联。
在这项横断面研究中，共评估了 174 名女性（平均年龄 33.9±7.6 岁），包括：（1）使用前瞻性每日评分评估当前 MRMD；（2）使用结构化访谈评估 CSA 史；（3）使用国际头痛疾病分类第二版标准评估 MA 和无先兆偏头痛。
96 名女性符合 MRMD 标准（其中 21 名有 CSA 史），78 名女性为非 MRMD 对照组（其中 16 名有 CSA 史）。与非 MRMD 对照组相比，有 MRMD 的女性 MA 更为常见（分别为 11/88 和 0/86，p=0.001）。仅在 MRMD 女性中，CSA 史与 MA 发生率较高相关（分别为 6/21 和 5/67，p=0.019）。即使在调整了潜在混杂因素后，当前 MRMD 诊断和 CSA 史的组合与 MA 的发生风险增加相关（比值比=12.08，95%置信区间 2.98-48.90，p<0.001）。
有 MRMD 的女性可能容易发生 MA，而有 MRMD 的女性 CSA 史似乎会增加这种易感性。MRMD 和 MA 应与其他不良的身心健康后果一起列入 CSA 史。对 CSA 史进行常规筛查可能会提高识别有遭受与 CSA 相关障碍风险的女性的能力。
