Frequent Migraines and Cephalalgiaphobia

Teri Robert @trobert Health Guide
  • In our information and discussions about Migraine, we've talked about terms with names that include the word phobia - phonophobia, photophobia, and osmophobia. One of the interesting points about these terms is that, in these cases, the word phobia means increased sensitivity to stimuli, not fear of them.


    There's another term with the word phobia in it where it does mean fear. That term is cephalalgiaphobia. In a recent study, Giannini et. al. defined cephalalgiaphobia as:

    "the fear of having a headache attack during a pain-free period that may induce patients to use analgesic in the absence of pain to prevent headache and to improve their performances."

    The study:

    Study background:

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    "This study aims at assessing if cephalalgiaphobia is related to migraine frequency or medication overuse, and if it is per se a predictor of increase in migraine frequency."

    Study methods:

    • The study participants were 126 consecutive Migraineurs, 24 male and 102 female, who were referred to a Migraine and headache center.
    • At baseline (the beginning), and again two years later, a Migraine specialist collected data on:
      • Migraine features,
      • Migraine frequency, and
      • medications.
    • Using a four-item questionnaire, cephalalgiaphobia was investigated at baseline and two years later. The questions were:
      1. When you are feeling well do you ever fear to have a migraine attack?
      2. Have you ever used painkillers even though you were not having pain just because you were scared of a possible migraine attack?
      3. Have you ever used a second dose of painkilling drugs just because you feared that the pain would get worse before it actually did?
      4. Have you ever used painkillers to improve your performances and be more active, although you were not feeling the pain at all?

    Study results:

    • Having moderate to high Migraine frequency was associated with a higher risk of cephalalgiaphobia.
    • Study participants with chronic Migraine and medication overuse had a higher cephalalgiaphobia score than those with chronic Migraine but no medication overuse.
    • Participants whose Migraine frequency increased between the questionnaire at baseline and the questionnaire two years later had higher cephalalgiaphobia scores.

    Study conclusions:

    "Cephalalgiaphobia may represent a high-frequency migraine feature and may play a role in chronicization. Therefore, it should be better investigated by clinicians and treated or prevented in order to reduce the risk of disability and the increase in migraine frequency."

    Summary and comments:

    Many Migraineurs live in fear of their next Migraine. This study demonstrates that more frequent Migraines and medication overuse increase cephalalgiaphobia and that increased cephalalgiaphobia may lead to increased disability and help lead to episodic Migraine becoming chronic. Migraineurs should be screened for cephalalgiaphobia, and it should be treated as part of an overall Migraine management strategy.




    Giannini, Guilia; Zanigni, Stefano; Grimaldi, Daniela; Merlotti, Roberto; Pierangeli, Guilia; Cortelli, Pietro; Cevoli, Sabina. "Cephalalgiaphobia as a feture of high-frequency migraine: a pilot study." The Journal of Headache and Pain 2013, 14:49


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    © Teri Robert, 2013
    Last updated November 18, 2013.

Published On: November 18, 2013