Association between psychological factors and headache burden in patients with migraine and tension-type headache: a systematic review and meta-analysis
Abstract
Abstract Purpose This study systematically reviewed the literature to identify psychosocial variables associated with headache burden including frequency, intensity, duration, disability, and quality of life in individuals with tension-type headache (TTH) and migraine. Methods A comprehensive search in PubMed/MEDLINE, PsycINFO, and CINAHL identified studies examining psychosocial factors and headache burden. Eligible studies were appraised for quality using the Joanna Briggs Institute checklist. Meta-analyses were performed for depression and anxiety, and certainty of evidence was evaluated using GRADE. Results Of 965 records screened, 30 studies met the inclusion criteria, including a total of 71 243 participants, identifying 17 psychosocial factors. Meta-analyses showed moderate-certainty evidence for positive associations between depression and anxiety with headache frequency. Narrative synthesis also indicated moderate-certainty evidence for several psychosocial factors across outcomes such as frequency, intensity, and disability, although most were supported by single studies. Which should be considered as a limitation. Other factors showed lower certainty due to methodological limitations or lack of adjusted analyses. Conclusions This review highlights the relevance of depression, anxiety, fear of pain, and self-efficacy in relation to headache burden in migraine and TTH. Incorporating psychosocial assessment into headache care may improve clinical reasoning and…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 71 participants or records.
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