Childhood traumas delineate a distinct psychological and clinical profile in adults with migraine: The hidden burden

Objective: This study aimed to explore how childhood trauma (CT) affects the psychological, clinical and demographic characteristics of migraine patients. Methods: A sample of subjects with chronic migraine with medication overuse (CM + MO) (n = 192) and episodic migraine (EM) (n = 84) was assessed for CT, psychological profiles (via DSM-5-based clinical interviews and self-report questionnaires) and migraine characteristics. Results: CT was detected in 40% of the total population, being more prevalent in the CM + MO subgroup (41%) versus the EM subgroup (36%) (p = 0.006). The CT group showed a higher prevalence of personality disorders (PDs), particularly Cluster B (12% vs. 4%) and Cluster C (60% vs. 34%), as well as psychopathologies (94% vs. 75%); p = 0.001). The CT group also exhibited greater anxiety, depression, alexithymia and exposure to current stressful life events (p = 0.001). CT participants were more frequently women, had an earlier migraine onset and a higher intake of acute medications. In the multivariate analysis, only Cluster C PDs (i.e., obsessive–compulsive PD), psychopathologies (i.e., anxiety disorders), stressful life events, difficulty identifying feelings (alexithymia), and female sex remained significant. Conclusions: CT is associated with psychological comorbidities, an earlier onset of migraine and a higher intake of acute medications, leading to a more complex migraine phenotype.