The Stigma of Migraine

Background: People who have a disease often experience stigma, a socially and culturally embedded process through which individuals experience stereotyping, devaluation, and discrimination. Stigma has great impact on quality of life, behavior, and life chances. We do not know whether or not migraine is stigmatizing. Methods: We studied 123 episodic migraine patients, 123 chronic migraine patients, and 62 epilepsy patients in a clinical setting to investigate the extent to which stigma attaches to migraine, using epilepsy as a comparison. We used the stigma scale for chronic illness, a 24-item questionnaire suitable for studying chronic neurologic diseases, and various disease impact measures. Results: Patients with chronic migraine had higher scores (54.0620.2) on the stigma scale for chronic illness than either episodic migraine (41.7614.8) or epilepsy patients (44.6616.3) (p,0.001). Subjects with migraine reported greater inability to work than epilepsy subjects. Stigma correlated most strongly with the mental component score of the short form of the medical outcomes health survey (SF-12), then with ability to work and migraine disability score for chronic and episodic migraine and the Liverpool impact on epilepsy scale for epilepsy. Analysis of covariance showed adjusted scores for the stigma scale for chronic illness were similar for chronic migraine (49.3; 95 % confidence interval, 46.2 to 52.4) and epilepsy (46.5; 95 % confidence interval, 41.6 to 51.6), and lower for episodic migraine (43.7; 95 % confidence interval, 40.9 to 46.6)