AUTHOR=Güler Aksu Gülen , Kayar Ozan , Tufan Ali Evren , Kütük Meryem Özlem , Özdağ Acarli Ayşe Nur , Sucu Damla Hazal , Taşdelen Bahar , Toros Fevziye , Özge Aynur TITLE=Early maladaptive schemas in episodic and chronic migraine in adolescents JOURNAL=Frontiers in Neurology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1128953 DOI=10.3389/fneur.2023.1128953 ISSN=1664-2295 ABSTRACT=Introduction

Psychotherapies, such as schema therapy, are receiving increasing attention in the management of pediatric headaches. The purpose of this study was to investigate early maladaptive schemas (EMSs) in adolescents with episodic migraine (EM) and chronic migraine (CM).

Methods

This clinic-based, cross-sectional study consisted of 167 adolescents, aged 12–18, who were diagnosed with EM (n = 140) and CM (n = 27). The clinical characteristics of migraine, its accompanying symptoms, EMSs, the interrelationship of EMSs, depression, and anxiety were evaluated. We specifically analyzed psychopathology and abuse history as covariates in this study.

Results

Defectiveness/shame, mistrust/abuse, abandonment/instability, enmeshment/undeveloped self, self-sacrifice, and subjugation schemas were more prevalent in the CM group. In terms of schema domains, the CM group scored significantly higher in disconnection/rejection and other orientations. Psychopathology did not affect the EMS scores, but a history of sexual abuse did. In patients with EM, a relationship was found between the variables of anxiety, depression, and five of the EMS domains. On the other hand, the CM group showed a significant relationship with anxiety, hypervigilance/inhibition, disconnection/rejection, and other orientation domains.

Discussion

This study highlights the value of EMSs, anxiety, and depression in young people with EM and CM. Schema therapy and schema-based therapeutic interventions should be researched, especially in pediatric migraine, as they may potentially prevent the progression to treatment-resistant migraine.