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BMC Neurol. 2019 Apr 4;19(1):53. doi: 10.1186/s12883-019-1284-8.

Global assessment of migraine severity measure: preliminary evidence of construct validity.

Author information

1
Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine 3280 Hospital Drive NW Calgary, Calgary, Alberta, T2N 4Z6, Canada. ttsajobi@ucalgary.ca.
2
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
3
Department of Community Health Sciences and O'Brien Institute for Public Health, University of Calgary, Cumming School of Medicine 3280 Hospital Drive NW Calgary, Calgary, Alberta, T2N 4Z6, Canada.
4
Department of Critical Medicine, University of Calgary, Calgary, Canada.
5
Department of Psychiatry, University of Calgary, Calgary, Canada.
6
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, USA.

Abstract

BACKGROUND:

In persons with migraine, severity of migraine is an important determinant of several health outcomes (e.g., patient quality of life and health care resource utilization). This study investigated how migraine patients rate the severity of their disease and how these ratings correlate with their socio-demographic, clinical, and psycho-social characteristics.

METHODS:

This is a cohort of 263 adult migraine patients consecutively enrolled in the Neurological Disease and Depression Study (NEEDs). We obtained a broad range of clinical and patient-reported measures (e.g., patients' ratings of migraine severity using the Global Assessment of Migraine Severity (GAMS), and migraine-related disability, as measured by the Migraine Disability Scale (MIDAS)). Depression was measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 14-item Hospital Anxiety and Depression Scale (HADS). Median regression analysis was used to examine the predictors of patient ratings of migraine severity.

RESULTS:

The mean age for the patients was 42.5 years (SD = 13.2). While 209 (79.4%) patients were females, 177 (67.4%) participants reported "moderately severe" to "extremely severe" migraine on the GAMS, and 100 (31.6%) patients had chronic migraine. Patients' report of severity on the GAMS was strongly correlated with patients' ratings of MIDAS global severity question, overall MIDAS score, migraine type, PHQ-9 score, and frequency of migraine attacks. Mediation analyses revealed that MIDAS mediated the effect of depression on patient ratings of migraine severity, accounting for about 32% of the total effect of depression. Overall, migraine subtype, frequency of migraine, employment status, depression, and migraine-related disability were statistically significant predictors of patient-ratings of migraine severity.

CONCLUSIONS:

This study highlights the impact of clinical and psychosocial determinants of patient-ratings of migraine severity. GAMS is a brief and valid tool that can be used to assess migraine severity in busy clinical settings.

KEYWORDS:

Construct validity; Depression; Disability; Global assessment of migraine severity; Migraine severity; Self-report

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