Posttraumatic Stress Disorder May Predict Headache-Related Disability After Traumatic Physical Injury

Woman with migraine
Woman with migraine
Investigators assessed single-incident traumatic physical injury survivors for symptoms of post-traumatic stress disorder and a composite of depression and anxiety symptoms.

Posttraumatic stress disorder (PTSD) is a valuable predictor for headache-related disability among individuals who have experienced a traumatic physical injury, according to a prospective observational study published in Headache.

Investigators assessed single-incident traumatic physical injury survivors (n=80) for symptoms of PTSD and a composite of depression and anxiety symptoms (negative affect [NA]). Specifically, researchers evaluated NA as the primary predictor of 6-week subacute and 3-month chronic headache-related disability.

Analysis revealed NA to be a significant predictor for subacute (Cohen’s ƒ2=0.130; P =.005) and chronic headache-related disability (Cohen’s ƒ2=0.160; P =.004) in this cohort. 

The predictive value of NA extended beyond that of demographic and injury-related factors, including sex, headache history, and closed head injury. Additional evaluation demonstrated an even greater predictive value of PTSD for subacute (Cohen’s ƒ2=0.105; P =.012) and chronic (Cohen’s ƒ2=0.103; P =.022) headache-related disability, which extended beyond injury-related and demographic factors, anxiety, and depression.

The investigators of this study retrospectively measured preinjury headache frequency at 6 weeks postinjury; thus, these preinjury data may not have been exact. In addition, the researchers were unable to infer causal conclusions regarding headache-related disability because of the lack of preinjury headache-related disability scores or headache diagnoses at baseline.

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Considering PTSD was found to be the best indicator for headache-related disability in physical traumatic injury survivors, the researchers suggest that early “screening for [PTSD] soon after trauma may more efficiently identify patients at risk than screening for all components of NA.”

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Pacella ML, Hruska B, George RL, Delahanty DL. The role of negative affect on headache-related disability following traumatic physical injury [published online November 28, 2017]. Headache. doi:10.1111/head.13233

This article originally appeared on Neurology Advisor