When parents suffer migraine, their adolescent children suffer as well, according to a web-based study conducted by investigators from the Chronic Migraine Epidemiology and Outcomes (CaMEO) study and published in Headache.
As such, CaMEO is the first study to include multiple perspectives from the migraine sufferer, spouse/partner, and adolescent or young adult children in the family. Previous data from CaMEO indicated that parental migraine reduced enjoyment in their children’s activities.
For this analysis, Dawn C. Buse, MD, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, and colleagues recruited and screened individuals with migraine using quota sampling from an Internet research panel comprising 2.4 million active US members. Respondents were classified as having either episodic migraine (EM) or chronic migraine (CM) based on headache frequency over the previous 3 months. EM was characterized as an average of < 15 headache days per month; CM was ≥ 15 headache days per month. Included were 1,243 parents with EM and 168 parents with CM.
Dr. Buse and colleagues also assessed the social, academic, and emotional effects in 1,411 adolescents 13 to 21 years old who were living with a parent who suffered from migraine. They included any child, grandchild, stepchild, or child for whom the respondent was a parent or guardian (the children did not have to be biologically related). If a household submitted data from two or more children, one child was chosen at random for inclusion.
Using a condensed adaptation of the Family Burden Module (adolescent version), the impact of the parent’s migraine was assessed in four domains: (1) loss of parental support and reverse caregiving; (2) emotional experience; (3) interference with school; and (4) missed activities and events.
In every domain, the perceived burden was greater for those whose parent had CM rather than EM. Effects noted by the adolescents included the need to assume household responsibilities and having to care for the parent (Domain 1); having parent argue or yell, feeling “let down” by the parent, or feeling angry (Domain 2); missing school or parent missing a school event (Domain 3).
In Domain 1, 32.9% of adolescents of a parent with CM and 9.8% of those with parents with EM reported having to take over a parent’s chores at least four times in the past 30 days (P < 0.001). Some 19.2% of the adolescents of a parent with CM had to stay home at least four times over the previous 30 days to take care of their parent, compared with 3.8% of those with a parent with EM (P < 0.001)
About one fourth (22.6%) of adolescents in the EM group missed a family outing and a similar percentage (22%) missed having friends visit them at home, but almost half of the adolescents with a parent with CM experienced those problems (46.5% and 48.1%, respectively).
The adolescent responders also reported feelings of depression and anxiety. Those with parents with CM experienced a significantly higher rate of moderate to severe anxiety than those with parents with EM (P=0.01).
"These results highlight the pervasive impact of a parent’s migraine on a wide range of important life domains, experiences, and emotions in adolescent youths, and together with spouse/partner data, provide additional context to better understand the full scope of the burden of migraine on the entire family,” wrote Dr. Buse and fellow researchers.
Among the strengths of this study were the large sample size designed to be representative of the general population of the US, data collection from multiple members of the same household, and the use of empirical domains and validated diagnostic instruments.
“Health care professionals should inquire about the family impact of migraine and consider inclusion of family members in patient education, treatment planning, and referral for psychotherapeutic treatment when necessary,” the authors concluded. “Effective migraine management may reduce the burden of migraine on the proband directly, and have indirect positive effects on family members. In addition, behavioral interventions (eg, cognitive behavioral therapy, family therapy, stress management training) may benefit both migraine probands and family members.”
This study was sponsored by Allergan plc (Dublin, Ireland).