Difficulties in Emotion Regulation and Psychiatric Symptoms in Adolescents Diagnosed with Migraine: A Case-Control Study

Introduction This study aims to evaluate difficulties in emotion regulation and accompanying psychiatric symptoms in adolescents diagnosed with migraine. Methods The study included 30 adolescents aged 12 to 18 years diagnosed with migraine and 30 age- and sex-matched healthy controls. Participants were assessed using the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), and the Revised Child Anxiety and Depression Scale (RCADS). Additionally, parents completed the Strengths and Difficulties Questionnaire (SDQ). Results Adolescents with migraine showed significantly greater difficulties in emotion regulation (DERS-16 total score, t = 3.521, p = 0.026, effect size = 0.64) and higher levels of depression, generalized anxiety and social anxiety (RCADS score t = 4.328, effect size = 1.32, p < 0.01; t = 2.354, effect size = 0.59, p = 0.022; t = 3.363, effect size = 1.12, p < 0.01, respectively) compared to controls. Parental assessments indicated higher internalizing and total difficulty scores in the migraine group (SDQ score z = 2.633, effect size = 048, p = 0.008; t = 2.419, effect size = 032, p = 0.016; t = 2.095, effect size = 029, p = 0.036, respectively). However, there were no significant group differences in the use of emotion regulation strategies (ERQ-CA score t = -0.236, p = 0.814; t = -0.957, p = 0.104, respectively). Conclusion This study highlights the psychological and emotional difficulties experienced by adolescents with migraine, emphasizing the importance of early psychiatric evaluation and psychotherapeutic interventions aimed at improving emotion regulation skills and psychosocial interventions focusing on lifestyle modifications as part of comprehensive migraine management. Limitations include the cross-sectional design, reliance on self-report measures, and modest sample size, which may limit generalizability. Future longitudinal and neurobiologically informed research is needed to clarify causal relationships and intervention targets.