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Comorbidity of migraine and fibromyalgia in patients with cluster headache: psychological burden and healthcare resource utilization. A cross-sectional study

  • Elena P. Calandre1,*,
  • Jorge L. Ordoñez-Carrasco2
  • Mahmoud Slim1,3
  • Fernando Rico-Villademoros1
  • Juan M. Garcia-Leiva1

1Institute of neurosciences, University of Granada, 18016 Granada, Spain

2Department of Psychology and Sociology, University of Zaragoza (Campus Teruel), 4403 Teruel, Spain

3Evidence Synthesis, Modelling & Simulation, Evidera, St. Laurent, QC H47 1V6, Canada

DOI: 10.22514/jofph.2024.004 Vol.38,Issue 1,March 2024 pp.32-39

Submitted: 08 January 2024 Accepted: 22 February 2024

Published: 12 March 2024

*Corresponding Author(s): Elena P. Calandre E-mail: epita@ugr.es

Abstract

The aim was to describe the comorbidity and impact of fibromyalgia and/or migraine on patients with cluster headache. Comorbid diseases can exacerbate the physical and psychological burden experienced by patients. The comorbidities of cluster headache have been scarcely investigated, with the exception of migraine, which is well-known to coexist with cluster headache. In contrast, the comorbidity of migraine and fibromyalgia has been well investigated and firmly established. An internet survey was uploaded to the webpage of a cluster headache patient association. The survey collected sociodemographic and clinical data, and patients completed questionnaires that assessed depression, sleep quality, health-related quality of life, and health care resource utilization (HCRU) over the preceding six months. Differences in total depression, sleep quality, and health-related quality of life scores among the groups were analyzed with the Kruskal-Wallis test, and differences in HCRU were analyzed with the chi-square test. Ninety-one patients with cluster headache participated in the survey; 39 (42.9%) experienced only cluster headache, 15 (16.5%) experienced cluster headache and migraine, 10 (11%) experienced cluster headache and fibromyalgia, and 27 (29.7%) experienced cluster headache with comorbid fibromyalgia and migraine. Moderate depression scores and positive suicidal ideation were found across all subgroups. Sleep quality and health-related quality of life were consistently poor across the different subgroups, with the cluster headache with comorbid fibromyalgia and migraine subgroup showing significantly lower scores. Heavy use of health care resources was observed across all subgroups, with no notable differences among them. The comorbidity of cluster headache with fibromyalgia and/or migraine does not seem to be infrequent. This comorbidity substantially increases the psychosocial burden experienced by patients and decreases their overall quality of life.


Keywords

Cluster headache; Fibromyalgia; Migraine; Psychosocial burden; Health care resource utilization


Cite and Share

Elena P. Calandre,Jorge L. Ordoñez-Carrasco,Mahmoud Slim,Fernando Rico-Villademoros,Juan M. Garcia-Leiva. Comorbidity of migraine and fibromyalgia in patients with cluster headache: psychological burden and healthcare resource utilization. A cross-sectional study. Journal of Oral & Facial Pain and Headache. 2024. 38(1);32-39.

References

[1] Fischera M, Marziniak M, Gralow I, Evers S. The incidence and prevalence of cluster headache: a meta-analysis of population-based studies. Cephalalgia. 2008; 28: 614–618.

[2] Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018; 38: 1–211.

[3] Ashina M, Katsarava Z, Do TP, Buse DC, Pozo-Rosich P, Özge A, et al. Migraine: epidemiology and systems of care. The Lancet. 2021; 397: 1485–1495.

[4] Song T, Lee MJ, Choi Y, Kim B, Chung P, Park J, et al. Differences in characteristics and comorbidity of cluster headache according to the presence of migraine. Journal of Clinical Neurology. 2019; 15: 334–338.

[5] Penn I, Chuang E, Chuang T, Lin C, Kao C. Bidirectional association between migraine and fibromyalgia: retrospective cohort analyses of two populations. BMJ Open. 2019; 9: e026581.

[6] Alciati A, Nucera V, Masala IF, Giallanza M, La Corte L, Giorgi V, et al. One year in review 2021: fibromyalgia. Clinical and Experimental Rheumatology. 2021; 39: 3–12.

[7] Joshi S, Rizzoli P, Loder E. The comorbidity burden of patients with cluster headache: a population-based study. The Journal of Headache and Pain. 2017; 18: 76.

[8] Lund N, Petersen A, Snoer A, Jensen RH, Barloese M. Cluster headache is associated with unhealthy lifestyle and lifestyle-related comorbid diseases: results from the Danish Cluster Headache Survey. Cephalalgia. 2019; 39: 254–263.

[9] Louter MA, Wilbrink LA, Haan J, van Zwet EW, van Oosterhout WPJ, Zitman FG, et al. Cluster headache and depression. Neurology. 2016; 87: 1899–1906.

[10] Alwhaibi M, Alhawassi TM. Humanistic and economic burden of depression and anxiety among adults with migraine: a systematic review. Depression and Anxiety. 2020; 37: 1146–1159.

[11] Yepez D, Grandes XA, Talanki Manjunatha R, Habib S, Sangaraju SL. Fibromyalgia and depression: a literature review of their shared aspects. Cureus. 2022; 14: e24909.

[12] Pei J, Wang X, Yu Y, Zhang Y, Gou L, Nan R, et al. Prevalence of suicidal ideation and suicide attempt in patients with migraine: a systematic review and meta-analysis. Journal of Affective Disorders. 2020; 277: 253–259.

[13] Gill H, Perez CD, Gill B, El-Halabi S, Lee Y, Lipsitz O, et al. The prevalence of suicidal behaviour in fibromyalgia patients. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2021; 108: 110078.

[14] Ji Lee M, Cho S, Wook Park J, Kyung Chu M, Moon H, Chung P, et al. Increased suicidality in patients with cluster headache. Cephalalgia. 2019; 39: 1249–1256.

[15] Robbins MS. The psychiatric comorbidities of cluster headache. Current Pain and Headache Reports. 2013; 17: 313.

[16] Bernik M, Sampaio TPA, Gandarela L. Fibromyalgia comorbid with anxiety disorders and depression: combined medical and psychological treatment. Current Pain and Headache Reports. 2013; 17: 358.

[17] Tiseo C, Vacca A, Felbush A, Filimonova T, Gai A, Glazyrina T, et al. Migraine and sleep disorders: a systematic review. The Journal of Headache and Pain. 2020; 21: 126.

[18] Wu Y, Chang L, Lee H, Fang S, Tsai P. Sleep disturbances in fibromyalgia: a meta-analysis of case-control studies. Journal of Psychosomatic Research. 2017; 96: 89–97.

[19] Barloese M, Lund N, Petersen A, Rasmussen M, Jennum P, Jensen R. Sleep and chronobiology in cluster headache. Cephalalgia. 2015; 35: 969–978.

[20] Negro A, Sciattella P, Spuntarelli V, Martelletti P, Mennini FS. Direct and indirect costs of cluster headache: a prospective analysis in a tertiary level headache centre. The Journal of Headache and Pain. 2020; 21: 44.

[21] Martelletti P, Schwedt TJ, Vo P, Ritrovato D, Reilly MC, Naclerio M, et al. Healthcare resource use and indirect costs associated with migraine in Italy: results from the My Migraine Voice survey. Journal of Medical Economics. 2021; 24: 717–726.

[22] Gendelman O, Shapira R, Tiosano S, Kuntzman Y, Tsur AM, Hakimian A, et al. Utilisation of healthcare services and drug consumption in fibromyalgia: a cross-sectional analysis of the Clalit Health Service database. International Journal of Clinical Practice. 2021; 75: e14729.

[23] Onder H, Hamamci M, Alpua M, Ulusoy EK. Comorbid fibromyalgia in migraine patients: clinical significance and impact on daily life. Neurological Research. 2019; 41: 909–915.

[24] Smarr KL, Keefer AL. Measures of depression and depressive symptoms: beck depression inventory-II (BDI-II), center for epidemiologic studies depression scale (CES-D), geriatric depression scale (GDS), hospital anxiety and depression scale (HADS), and patient health questionnaire-9 (PHQ-9). Arthritis Care & Research. 2011; 63: S454–S466.

[25] Baader M T, Molina F JL, Venezian B S, Rojas C C, Farías S R, Fierro-Freixenet C, et al. Validation and usefulness of the PHQ-9 (Patient Health Questionnaire) for the diagnosis of depression in primary care patients in Chile. Revista Chilena de Neuro-psiquiatría. 2012; 50: 10–22.

[26] Morin CM, Belleville G, Bélanger L, Ivers H. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011; 34: 601–608.

[27] Fernandez-Mendoza J, Rodriguez-Muñoz A, Vela-Bueno A, Olavarrieta-Bernardino S, Calhoun SL, Bixler EO, et al. The Spanish version of the insomnia severity index: a confirmatory factor analysis. Sleep Medicine. 2012; 13: 207–210.

[28] EQ-5D-5L User Guide, version 3.0. 2019. Available at: https://euroqol.org/publications/user-guides/ (Accessed: 29 March 2023).

[29] Garcia-Gordillo MA, Adsuar JC, Olivares PR. Normative values of EQ-5D-5L: in a Spanish representative population sample from Spanish Health Survey, 2011. Quality of Life Research. 2016; 25: 1313–1321.

[30] Gasparini M, Bonito V, Leonardi M, Tarquini D, Colombi L, Congedo M, et al. Neurologists and patients’ associations: alliances and conflicts. Neurological Sciences. 2006; 27: 194–204.

[31] Kim B, Chung P, Kim B, Lee MJ, Park JW, Chu MK, et al. The impact of remission and coexisting migraine on anxiety and depression in cluster headache. The Journal of Headache and Pain. 2020; 21: 58.

[32] Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache: The Journal of Head and Face Pain. 2012; 52: 99–113.

[33] de Coo IFM, Jesse S, Le T, Sala C, Bourgeron T. Consensus recommendations on Epilepsy in Phelan-McDermid syndrome. European Journal of Medical Genetics. 2023; 66: 104746.

[34] Liaw Y, Wang Y, Chen W, Chen S, Wu J, Chen S, et al. Sex-related differences in cluster headache: a hospital-based study in Taiwan. Cephalalgia. 2022; 42: 1532–1542.

[35] Stanyer EC, Creeney H, Nesbitt AD, Holland PR, Hoffmann J. Subjective sleep quality and sleep architecture in patients with migraine. Neurology. 2021; 97: e1620–e1631.

[36] Duan S, Ren Z, Xia H, Wang Z, Zheng T, Liu Z. Association between sleep quality, migraine and migraine burden. Frontiers in Neurology. 2022; 13: 955298.

[37] Calandre EP, Garcia-Leiva JM, Ordonez-Carrasco JL. Psychosocial variables and healthcare resources in patients with fibromyalgia, migraine and comorbid fibromyalgia and migraine: a cross-sectional study. International Journal of Environmental Research and Public Health. 2022; 19: 8964.

[38] D’Amico D, Raggi A, Grazzi L, Lambru G. Disability, quality of life, and socioeconomic burden of cluster headache: a critical review of current evidence and future perspectives. Headache: The Journal of Head and Face Pain. 2020; 60: 809–818.

[39] Pohl H, Gantenbein AR, Sandor PS, Schoenen J, Andrée C. The impact of the disease burden on the quality of life of cluster headache patients. Cephalalgia Reports. 2021; 4: 251581632110299.

[40] Salaffi F, Sarzi-Puttini P, Girolimetti R, Atzeni F, Gasparini S, Grassi W. Health-related quality of life in fibromyalgia patients: a comparison with rheumatoid arthritis patients and the general population using the SF-36 health survey. Clinical and Experimental Rheumatology. 2009; 27: S67–S74.

[41] Domitrz I, Golicki D. Health-related quality of life in migraine: EQ-5D-5L-based study in routine clinical practice. Journal of Clinical Medicine. 2022; 11: 6925.

[42] Serdaroglu Beyazal M, Tufekci A, Kirbas S, Topaloglu MS. The impact of fibromyalgia on disability, anxiety, depression, sleep disturbance, and quality of life in patients with migraine. Noro Psikiyatri Arsivi. 2018; 55: 140–145.

[43] Choong CK, Ford JH, Nyhuis AW, Robinson RL, Aurora SK. Health care utilization and direct costs among patients diagnosed with cluster headache in U.S. health care claims data. Journal of Managed Care & Specialty Pharmacy. 2018; 24: 921–928.

[44] Polson M, Lord TC, Evangelatos TM, Lopes M, Santaniello BL. Real-world health plan claims analysis of differences in healthcare utilization and total cost in patients suffering from cluster headaches and those without headache-related conditions. The American Journal of Managed Care. 2017; 23: S295–S299.


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