Impulsivity among migraine patients in a series of 239 cases: Analyzing subscales of Plutchik Scale

Introduction Impulsivity may be related to an anxious anticipation of pain. It might explain an increased consumption of symptomatic treatments in migraine patients, one of main risk factors for Chronic Migraine (CM). Plutchik Scale (PS) is a screening test designed to assess impulsive behaviours grouped in four subscales: ability to plan, control of emotional states, control of basic behaviours, and control of other behaviours. We aim to analyze influence of impulsivity on CM or Medication Overuse (MO). Methods Patients attended in an outpatient headache office in a tertiary hospital (January 2013–January 2015). Episodic migraine (EM), CM and MO diagnosed accordingly to International Classification of Headache Disorders, III edition. Patients answered PS (15 multiple choice items, positive if score>20). We analysed results including four subscales. Results Two hundred and thirty-nine patients (34 males, 205 females), age 38.1±11years (range: 18–70). One hundred and sixty-one cases (67.4%) CM and, among them, 115 (71.4%) with MO. Plutchik score 13.1±6.8 (1–40); 36 patients (15.1%) met criteria for impulsivity. Considering subscales 12.6% of patients were over the cut-point regarding ability to plan, 20.5% for emotional states, 4.6% for common behaviours and 26.4% for other behaviours. We found no differences in Plutchik or subscales scores or presence of impulsivity when comparing EM and CM groups and CM patients with or without MO. Conclusion In our migraine population, impulsivity assessed by Plutchik scale is frequent, mainly when considering emotional states or common behaviours. However, neither Plutchik nor subscales scores correlated with CM or MO.