Migraine and Work – Beyond Absenteeism Migraine Severity, Occupational Burnout and Commuting Time – A Cohort Study
Authors: Peles Ido , Sharvit Shaked , Zlotnik Yair , Gordon Michal , Novack Victor , Waismel-Manor Ronit , Ifergane Gal 
Published: June 2024

Background
Migraine, a prevalent cause of disability, significantly impacts work productivity, particularly within the prime age range of 25 to 55 years. This cohort study delves into the complex relationship between migraine severity, occupational burnout, and commuting time. Going beyond traditional indicators of work impairment like absenteeism and presenteeism, our research explores additional work-related consequences of migraine, such as decisions regarding workplace proximity and reduced engagement at work. By investigating the connections between migraine severity, psychiatric comorbidities, commuting durations, and occupational burnout, our study aims to offer a more comprehensive understanding of the broader impacts of migraine on employment.
Methods
Focus groups of migraine patients highlighted burnout and commuting as significant migraine-related concerns. A subset of participants from the Negev Migraine Cohort, including both migraine sufferers and control subjects, were systematically enlisted to complete our study questionnaire. The questionnaire covered demographic information, health status, and employment details. Additionally, levels of depression, anxiety, and stress were assessed using the DASS-21 scale, while migraine severity was gauged by migraine frequency and the MIDAS score. Occupational burnout was measured using the MBI-GS scale. Statistical analysis, incorporating descriptive, univariate, and multivariate methods, was employed to identify correlations and adjust for pertinent variables.
Results
A total of 675 migraine patients and 232 control subjects participated in the study. Migraine patients, who were predominantly female and younger compared to the controls, exhibited higher rates of depression, anxiety, and stress. However, there was no significant difference in self-rated health between the two groups. Despite similar employment rates, migraine patients tended to work longer hours and expressed a preference for remote work. Notably, migraine patients reported higher levels of occupational burnout than controls, with a notable correlation to psychological distress. Among migraine patients, men reported experiencing higher levels of burnout. After controlling for depression, anxiety, and stress, migraine severity was found to be correlated with occupational burnout. Although commuting times were similar for both groups, higher migraine severity was associated with shorter commuting times, particularly among men.
Conclusions
The study reveals that migraine severity serves as an independent predictor of occupational burnout, even when considering psychiatric comorbidities associated with migraine. Interestingly, men with migraine report elevated levels of burnout, contrary to conventional gender expectations. This may be attributed to migraine-related cognitive disturbances intensifying cognitive overload at work, thereby increasing the likelihood of occupational burnout. Interestingly, men with migraine report elevated levels of burnout, contrary to previous reports. Moreover, a higher severity of migraine is linked to shorter commuting times, indicating a tendency for migraine patients to avoid travel, which in turn limits their employment options. The preference among migraine patients for remote work aligns with this observation. Although the study may be limited by potential sample bias, its findings underscore the necessity for workplace adjustments to allow migraine sufferers to achieve maximal occupational capacity.