The role of sexual dysfunction and attachment style in migraine related quality of life

Background: Migraine is a disabling condition affecting quality of life and social relations worldwide. To date few studies have focused on the occurrence and possible role of sexual dysfunction in migraine patients quality of life [1,2]. Attachment behaviour is supposed to influence psychological and physical well-being, coping, illness be- haviour and social functioning [2]. Objectives: This study was conducted to investigate the association among sexual dysfunction, psychological factors, attachment style and quality of life, in a sample of migraine patients. Patients and Methods: 70 adult migraine outpatients (14 males; 56 females, mean age 39,56±12,55) consecutively referred to Headache Centre, were recruited and submitted to: a) the International Index ofErectile Function (IIEF) for male patients, b) the Female Sexual Function Index (FSFI) for female patients, c) 36-Item Short Form Health Survey (SF-36), d) Symptom Check List 90 Response (SCL-90R), e) Attachment Style Questionnaire (ASQ). Results: FSFI- IIEF Sexual dysfunction was found in 54,30% of the whole sample (males: 42,85% vs females: 57,14%, p=0,38), without difference according to age, marital status, job and migraine type (with or without aura). Sexual Dysfunction was observed more frequently in chronic migraine patients than in episodic ones (73,07% vs 40,62%, p=0.02). Migraine patients with sexual dysfunction showed significantly lower scores in SF-36 Mental Component Summary (41,52+10,88 vs47,12+9,41, p=0,02) and in ASQ Confidence subscale (31,39+8,15 vs 35,87±5,55, p=0,01). No difference was found between patients with and without Sexual dysfunction both in SCL-90R Anxiety (57,93±12,26 vs 51,69+14,37, p=0,07) and Depression (53,93±15,80 vs 46,79+12,71, p=0,08) subscales scores. A positive bivariate correlation was observed in the whole sample between SF-36 Mental Component Summary and ASQ Confidence subscale(r=0,37, p=0,001) whereas a negative correlation was found between SF-36 Mental Component Summary and both ASQ sub- scales: Discomfort with Closeness (r=-0,23, p=0,04), and Preoccupa- tion with relationships (r=-0,37,p=0.001). Conclusions: This study supports the role of Sexual dysfunction as an independent factor than anxiety and depression in migraine related quality of life. Migraine patients with insecure attachment both with and without sexual dysfunction showed worse quality of life. Future longitudinal studies including larger populations are requested to confirm these results.