Relationship Between Perceived Stress, Resilience, Mental Health, and Pain in Women with Migraines, a Case-Control Study.

Purpose: The protective role of resilience against migraine remains understudied, and the present study examined the role of resilience in the relationship between perceived stress, mental health, and pain in female migraineurs and healthy women. Patients and methods: In this case-control study, 125 female migraineurs and 121 healthy female controls were included. The Perceived Stress Scale (PSS-13), Connor-Davidson Resilience Scale (CD-RISC-10), and SF12 health-related quality-of-life questionnaire were used for assessments mental (MCS) and physical (PCS) health condition. Correlation and mediation analyses were performed. Results: Female migraineurs exhibited significantly higher perceived stress, lower resilience, and worse quality of life, including pain and MCS (all p < 0.05). Resilience partially mediated the relationship between perceived stress and MCS in healthy women, but not in migraineurs. Mental health fully mediated the relationship between perceived stress and pain in migraineurs, while in healthy women, both resilience and MCS sequentially mediated this relationship. Conclusion: Resilience does not protect against the mental health impact of perceived stress in female migraineurs but has a partial protective effect in healthy women. Mental health mediates the impact of perceived stress on pain among migraineurs. These findings underscore the need for targeted stress management and resilience-building interventions in clinical practice for better outcomes in women with migraines.