Illness perception in patients with chronic migraine: cognitive, emotional and behavioral aspects

In patients with chronic migraine (CM), the illness perception includes three main aspects: cognitive (thoughts, beliefs, attitude towards pain), emotional (mood) and behavioral (pain coping strategies). The patient’s perception affects the course of CM, the prognosis and personality of the patient, so its assessment, understanding and correction underlie a multidisciplinary approach to treatment.
Objective: to evaluate the cognitive, emotional and behavioral characteristics of patients with CM.
Material and methods. The study included 200 patients with CM (63 men and 137 women), mean age 33.1±7.1 years. All patients were interviewed and tested to assess their clinical, cognitive, emotional and behavioral characteristics.
Results. High levels of indicators such as catastrophizing of symptoms (84%), autonomic sensations (89%), intolerance to bodily sensations (71%), overestimation of the severity of symptoms (91%), and bodily weakness (68%) were revealed. All patients had misconceptions about the causes of headache, the majority (80%, n=160) had misconceived negative ideas about the prognosis. Almost all patients had high situational (95%, n=190) and personal (90%, n=180) anxiety, depressive symptoms of varying severity (95%, n=190). Non-adaptive pain coping strategies prevailed: avoidance coping style (87%, n=174); emotion-oriented coping (76%, n=152). In a group of 20 patients significant (p<0.05) associations were found between catastrophizing of symptoms, autonomic sensations, overestimating the severity of symptoms, anxiety and depression, and coping strategies.
Conclusion. In most patients with CM, the illness perception includes negative and misconceived ideas about headache, clinically expressed symptoms of anxiety and depression, and maladaptive coping strategies. Significant relationships were found between cognitive, emotional, and behavioral characteristics, which emphasizes the validity and positive perspective of using the cognitive-behavioral model of pain in CM treatment.

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