Department of Child and Adolescent Psychiatry, Mersin University School of Medicine, Mersin, Turkey.
Department of Psychology, Çankırı Karatekin University, Çankırı, Turkey.
Brain Dev. 2022 Aug;44(7):427-437. doi: 10.1016/j.braindev.2022.04.001. Epub 2022 Apr 19.
Despite many diverse findings from studies about the comorbidity of psychiatric disorders and migraine, there are still unknown points. Schemas, which are the basic structures of cognition, are understudied. This study examined the effects of sex on early maladaptive schemas (EMSs) and the clinical characteristics of migraine in adolescents with migraine.
The sample comprised 171 adolescents (67.3% females, n = 115) aged 12-18 years. The clinical characteristics of migraine (duration, severity, frequency of headaches, etc.), accompanying symptoms (nausea, vomiting, photophobia, etc.) and EMSs were evaluated depending on sex. Psychopathology and abuse history were analyzed as covariates in this study.
The mean age was 15.4 ± 1.9 among the females and 15.2 ± 2.0 among the males (p = 0.65). There was no difference in terms of migraine characteristics, and except for dizziness and pain relief by massage, all other symptoms were similar between the sexes. Female adolescent migraineurs significantly elevated scores for EMS of emotional deprivation, abandonment/instability, defectiveness/shame (disconnection/rejection domain), dependence/incompetence, vulnerability to harm/illness, failure (in impaired autonomy/performance domain) and negativity/pessimism (in hypervigilance/inhibition domain). On the other hand, male migraineurs had significantly elevated scores only in insufficient self-control/self-discipline (in impaired limits domain). Type of migraine and current psychopathology had no significant effect on the EMS domains, while sexual abuse history significantly affected some EMS.
Our study highlights the importance of screening for EMSs among adolescent patients with migraine. Schema therapy and similar therapeutic interventions may be used in the management of migraine in adolescents. Gender may also be important factor the schema therapy in adolescent migraine patients.
尽管许多关于精神障碍和偏头痛共病的研究得出了不同的结果，但仍有一些未知的问题。认知的基本结构——图式，研究得还不够充分。本研究旨在探讨性别对青少年偏头痛患者早期适应不良图式（EMS）和偏头痛临床特征的影响。
该样本包括 171 名 12-18 岁的青少年（67.3%为女性，n=115）。根据性别评估偏头痛的临床特征（持续时间、严重程度、头痛频率等）、伴随症状（恶心、呕吐、畏光等）和 EMS。本研究将精神病理学和滥用史作为协变量进行分析。
女性的平均年龄为 15.4±1.9 岁，男性为 15.2±2.0 岁（p=0.65）。偏头痛特征无差异，除头晕和按摩缓解头痛外，其他症状在性别间相似。女性青少年偏头痛患者的情感剥夺、遗弃/不稳定、缺陷/羞耻（分离/拒绝领域）、依赖/无能、易受伤害/疾病、失败（受损自主/表现领域）和消极/悲观（过度警惕/抑制领域）的 EMS 评分显著升高。另一方面，男性偏头痛患者仅在自我控制/自我约束不足（受限领域）的 EMS 评分显著升高。偏头痛类型和当前精神病理学对 EMS 无显著影响，但性虐待史对某些 EMS 有显著影响。
本研究强调了对青少年偏头痛患者进行 EMS 筛查的重要性。图式疗法和类似的治疗干预措施可用于青少年偏头痛的管理。性别可能也是青少年偏头痛患者图式治疗的一个重要因素。
