Abstract Details

MIDAS is a clinical tool to measure disability in migraine patients.  However, discordance between MIDAS scores and functional ability occur in clinical practice.  Based on these discrepancies, we investigated whether MIDAS was also an indicator of resilience.

To correlate the degree of headache disability as assessed by the Migraine Disability Assessment (MIDAS) with measures of resilience (Connor Davidson Resilience Scale, CD-RISC), determine whether the level of resilience modified the association between headaches severity/frequency and disability, and assess the association between anxiety and depression with resilience in headache patients.

We prospectively recruited patients with primary headache disorders seen in an academic, tertiary Headache Medicine program between 02/20/2018 and 08/02/2019.  Each participant (n=160) completed 5 validated measures in the clinic: MIDAS, CD-RISC-25, Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7) and WHO Well-Being Index (WHO-5).

Consistent with our hypothesis, the CD-RISC-25 score negatively correlated with total MIDAS score (r= -.0.21, p=0.0091), total GAD-7 score (r= -0.56, p<.0001) and total PHQ-9 score (r=-0.34, p<.0001). Logistical regression models showed negative associations between resilience and headache-related disability, anxiety and depression.  A one point increase in the CD-RISC-25 score decreased the odds of being severely disabled by 4% (OR = 0.96, p=0.001).  After adjusting for resilience score and age, only the total GAD-7 score was associated with severe disability, with a one-point increase in total GAD-7 score increasing the odds of severe disability by 16% (OR=1.16, p<.001).  Similarly, a one point increase in total PHQ-9 score, increased the odds of being severely disabled by 24% (OR=1.24, p<.001).

A higher resilience score inversely correlated with headache-related disability in this cohort.  Higher levels of anxiety and depression were associated with increased levels of headache-related disability.