新冠疫情对偏头痛青年成人患者头痛相关失能的影响。

Thaxter Lauren Y, Smitherman Todd A

Department of Psychology, University of Mississippi, Oxford, Mississippi, USA.

Headache. 2022 Nov;62(10):1293-1301. doi: 10.1111/head.14411. Epub 2022 Nov 23.

OBJECTIVE

The present study aimed to explore the relationship between the COVID-19 pandemic and headache-related disability among a sample of young adults with migraine.

BACKGROUND

Comorbid psychological symptoms compound migraine-related disability. Due to COVID-19 pandemic procedures, many students experienced institutional closures and corresponding increases in depression, stress, and anxiety. The present study sought to examine changes in headache-related disability before (Spring and Fall of 2019) and during (Fall of 2020 and Spring 2021) the COVID-19 pandemic and whether psychological symptoms mediated such changes.

METHODS

A cross-sectional study at a southern U.S. university assessed 365 individuals with migraine on headache and psychological variables, comparing those surveyed before COVID-19 with another group surveyed during the pandemic. The direct and indirect effects of COVID-19 status (pre- versus during COVID-19) on headache-related disability through depression, anxiety, and stress symptoms were assessed.

RESULTS

Statistically higher levels of depression, (M = 13.9 [SD = 12.2] vs. M = 8.7 [SD = 8.7], p < 0.001), anxiety (12.3 [10.0] vs. 9.7 [8.2], p = 0.01), and stress symptoms (17.6 [10.2] vs. 13.2 [7.9], p < 0.001) were endorsed during the COVID-19 pandemic. The direct path from COVID-19 status to headache-related disability was significant and negative, c' = -1.6 (95% CI: -3.1, -0.1). Anxiety (b = 0.3 [95% CI: 0.01, 0.9]) and depression (b = 0.7 [95% CI: 0.07, 1.4]) symptoms acted as mediators of this relationship, rendering the total effect nonsignificant and negating the lowered disability observed during the pandemic. Only depression symptoms remained a significant mediator after controlling for headache frequency (b = 0.7 [95% CI: 0.09, 1.4]).

CONCLUSIONS

Increased depression and anxiety symptoms attenuated the improvements in disability associated with the pandemic. As such, interventions that address comorbid psychological symptoms may hold value in reducing headache-related disability and improving outcomes for young adults whose headache developed or worsened during the COVID-19 pandemic.

目的

本研究旨在探讨新冠疫情与偏头痛年轻成年人样本中头痛相关残疾之间的关系。

背景

共病心理症状会加重偏头痛相关残疾。由于新冠疫情防控措施，许多学生经历了学校关闭，抑郁、压力和焦虑相应增加。本研究旨在调查新冠疫情之前（2019年春季和秋季）和期间（2020年秋季和2021年春季）头痛相关残疾的变化，以及心理症状是否介导了这种变化。

方法

美国南部一所大学的横断面研究评估了365名偏头痛患者的头痛和心理变量，将新冠疫情之前接受调查的人与疫情期间接受调查的另一组人进行比较。评估了新冠疫情状态（新冠疫情之前与期间）通过抑郁、焦虑和压力症状对头痛相关残疾的直接和间接影响。

结果

在新冠疫情期间，抑郁（M = 13.9 [标准差 = 12.2] 对 M = 8.7 [标准差 = 8.7]，p < 0.001）、焦虑（12.3 [10.0] 对 9.7 [8.2]，p = 0.01）和压力症状（17.6 [10.2] 对 13.2 [7.9]，p < 0.001）在统计学上有更高水平。从新冠疫情状态到头痛相关残疾的直接路径显著且为负，c' = -1.6（95%置信区间：-3.1，-0.1）。焦虑（b = 0.3 [95%置信区间：0.01，0.9]）和抑郁（b = 0.7 [95%置信区间：0.07，1.4]）症状是这种关系的中介，使总效应不显著，并抵消了疫情期间观察到的残疾降低。在控制头痛频率后，只有抑郁症状仍然是显著的中介因素（b = 0.7 [95%置信区间：0.09，1.4]）。