Eating attitudes of migraine patients in Turkey: a prospective multi-center study
Authors: Ocal Ruhsen , Karakurum-Goksel Basak , Van Mert , Coskun Ozlem , Karaaslan Cihad , Ucler Serap , Gokcay Figen , Celebisoy Nese , Sirin Hadiye , Kisabay Ak Aysin , Saritas Aysegul Seyma , Cerrahoglu Sirin Tuba , Hasirci Bayir Buse Rahime , Ekizoglu Esme , Orhan Elif Kocasoy , Bayram Derya , Tanik Nermin , Bicakci Sebnem , Ozturk Vesile , Inan Levent Ertugrul , Metin Kubra Mehel , Eren Yasemin , Dora Babur , Oguz-Akarsu Emel , Karli Necdet , Celik Emel Ur , Atalar Arife Cimen , Gozubatik Celik Rabia Gokcen , Mutluay Belgin , Aydinlar Elif Ilgaz , Yalinay Dikmen Pinar , Semercioglu Sencer , Emre Ufuk , Buldukoglu Osman Cagin , Er Busra , Kilboz Bekir Burak , Ibis Seray , Yagiz Sibgetullah , Koklu Huzeyfe , Kamaci Ibrahim , Aliyeva Gulshan , Ates Basak Elcin , Kara Muge Mercan , Altunc Fatma Zehra , Kaya Ilgin , Sisman Cagla 
Published: May 2024

Abstract
Background
Migraine is a disease characterized by headache attacks. The disease is multifactorial in etiology and genetic and environmental factors play role in pathogenesis. Migraine can also be accompanied by psychiatric disorders like neurotism and obsessive compulsive disorder. Stress, hormonal changes and certain food intake can trigger attacks in migraine. Previous studies showed that eating attitudes and disorders are prevalant in patients with migraine. Eating disorders are psychiatric disorders related to abnormal eating habits. Both migraine and eating disorders are common in young women and personality profiles of these patient groups are also similar. A possible relationship which shows that migraine and eating habits are related can lead to a better understanding of disease pathogenesis and subsequently new therapeutic options on both entities. Association of migraine in relation to severity, depression and anxiety and eating habits and disorders were aimed to be investigated in this study.

Methods
The study was designed as a prospective, multi-center, case control study. Twenty-one centers from Turkey was involved in the study. The gathered data was collected and evaluated at a single designated center. From a pool of 1200 migraine patients and 958 healthy control group, two groups as patient group and study group was created with PS matching method in relation to age, body-mass index, marital status and employment status. Eating Attitudes Test-26 (EAT-26), Beck’s Depression Inventory (BDI) and Beck’s Anxiety Inventory (BAI) were applied to both study groups. The data gathered was compared between two groups.

Results
EAT-26 scores and the requirement for referral to a psychiatrist due to symptoms related to eating disorder were both statistically significantly higher in patient group compared to control group (p = 0.034 and p = 0.0001 respectively). Patients with migraine had higher scores in both BDI and BAI compared to control group (p = 0.0001 and p = 0.0001 respectively). Severity of pain or frequency of attacks were not found to be related to eating attitudes (r:0.09, p = 0.055).

Conclusions
Migraine patients were found to have higher EAT-26, BDI and BAI scores along with a higher rate of referral to a psychiatrist due to symptoms. Results of the study showed that eating habits are altered in migraine patients with higher risk of eating disorders. Depression and anxiety are also found to be common amongst migraine patients.