Migraine and Stress – An Explorative Cross-Country Study of External Stress Factors

Background: According to the Global Burden of Disease 2016 project, migraine ranks first for 15-49 years and second for all ages. The project has reported no significant relation with socio-economic status of a country. To the contrary, migraine ranks first for all ages in low- and middle-income countries suffering from civic unrest and conflict. This raises the question whether external stress factors may be correlated with migraine years lived with disability (YLD). Methods: In the absence of cross-country studies on migraine and stress, this is a unique exploratory study. The analysis uses two country groups: developed countries (including some middle-income countries) and developing (middle- and low-income) countries. For the first group, proxy variables for stress are included that relate to flexible and highly competitive labour markets (productivity and unemployment), whereas for the second group, proxy variables are used that relate to conflict and migration. The data were analysed with multiple ordinary least squares cross-section regressions. Results: The results show a positive relationship between the stress variables on the one hand and migraine YLD on the other hand for both country groups. Almost all results are statistically significant at p<0.01. Conclusions: The findings from the exploratory cross-country analysis suggest that societal stress factors may be potential candidates for modifiable factors for the prevalence and severity of migraine at the country level.