“Daily” Common Migraine: Psychosocial Predictors of Outcomes of Medical Therapy

SYNOPSIS A group of 25 patients was treated with prophylactic medication for daily or near-daily common migraine. Twelve patients (48%) improved on therapy while the remainder did not respond. Psychosocial factors were examined as they related to outcomes. The most important measured predictor of successful treatment was the perception by the patient that headaches were related to emotional stress; 92% of responders held this view compared to only 8% of nonresponders. Responders were also more likely to be divorced or never married and to seek psychotherapy than were nonresponders, most of whom were married and avoided psychotherapy. Patient age, sex, and perceived life stresses were unrelated to the results of treatment. It appears that patterns of responses to emotional stress are significant correlates of outcomes of prophylactic medical therapy.