Anger experience in migraine without aura patients

Aim. The association between migraine and several psychiatric conditions has been widely described in literature. However, even if the involvement of negative affects in the experience of pain has been debated, little is still known about the role of anger in both migraine and its psychiatric comorbidity. We assessed depression, anxiety and anger by means of three self-rating scales in two groups of subjects: the case group, composed of migraine without aura patients and the control group, composed of healthy volunteers, in order to examine the anger experience and its relationship with depression and anxiety. Methods. One hundred and four consecutive patients suffering from migraine without aura were enrolled in the study and compared to a control group of 54 healthy volunteers. All subjects completed the following psychometric tests: Zung Self-Rating Depression Scale (SDS), State-Trait Anxiety Inventory (STAI) and State-Trait Anger Expression Inventory (STAXI). Analysis of variance and logistic regression were performed. Results. Migraine patients scored significantly higher in depression, anxiety and anger scales showing significant lower values in anger control when compared with healthy subjects. Logistic regression showed that only depression is predictive of anger turned inward while the attacks frequency is the only predictor of anger turned outward. We also found that anger expression was influenced by depression index and by the attacks frequency. Conclusion. Our data show that in migraine without aura patients the level of depression plays a crucial role in anger expression, mainly consisting of an amplified angry reaction turned both inward and outward.