Childhood traumas delineate a distinct psychological and clinical profile in adults with migraine: The hidden burden

Objective This study aimed to explore how childhood trauma (CT) affects the psychological, clinical and demographic characteristics of migraine patients. Methods A sample of subjects with chronic migraine with medication overuse (CM + MO) (n = 192) and episodic migraine (EM) (n = 84) was assessed for CT, psychological profiles (via DSM-5-based clinical interviews and self-report questionnaires) and migraine characteristics. Results CT was detected in 40% of the total population, being more prevalent in the CM + MO subgroup (41%) versus the EM subgroup (36%) ( p = 0.006). The CT group showed a higher prevalence of personality disorders (PDs), particularly Cluster B (12% vs. 4%) and Cluster C (60% vs. 34%), as well as psychopathologies (94% vs. 75%); p = 0.001). The CT group also exhibited greater anxiety, depression, alexithymia and exposure to current stressful life events ( p = 0.001). CT participants were more frequently women, had an earlier migraine onset and a higher intake of acute medications. In the multivariate analysis, only Cluster C PDs (i.e., obsessive–compulsive PD), psychopathologies (i.e., anxiety disorders), stressful life events, difficulty identifying feelings (alexithymia), and female sex remained significant. Conclusions CT is associated with psychological comorbidities, an earlier onset of migraine and a higher intake of acute medications, leading to a more complex migraine phenotype .