COVID-19 and Headache-Related Disability

Migraine is a common nervous system disorder that is a leading cause of disability worldwide, and approximately half of individuals with migraine report their migraine attacks cause substantial impairment in activities. A bidirectional relationship exists between migraine and psychological symptoms, and comorbid psychological symptoms compound migraine-related disability. Due to COVID-19 pandemic response procedures, many university students experienced institutional closures and corresponding increases in depression, stress, and anxiety, with the most prominent worries being about one\u27s own health and the health of loved ones. The present study aimed to explore the relationship between COVID-19 status (pre-COVID vs. during COVID) and headache-related disability among a sample of young adults with migraine, and whether depression, anxiety, and stress act as parallel mediators in this relationship. The results revealed significantly higher levels of depression, anxiety, and psychological stress symptoms during the COVID-19 pandemic compared to before the COVID-19 pandemic but not consistently worsened headache or headache disability. Comorbid depression and anxiety symptoms served a mediating role between COVID-19 status and headache-related disability, such that they increased COVID-related disability. When headache frequency was controlled for, only depression symptoms remained a significant mediator of the relationship between COVID-19 status and headache-related disability. Comorbid depression and anxiety symptoms among patients with high headache-related disability, particularly those whose migraine developed or worsened during the pandemic, may be an important target of treatment