Migraine and Work-Family Conflict: A Gender Analysis
Considerations on the Relationship Between Migraine and Work-Family Conflict (Peles et al., 2025)
1. Overview
This briefing document summarizes the key themes and significant findings of the study by Peles et al. (2025), "Invisible burdens: Gender-specific associations between migraine and work–family conflict – Insights from the SMILE project – a cohort study." This study examines how the diagnosis and severity of migraine are associated with work-family conflict (WFC), stratified by gender.
2. Key Themes and Significant Findings
2.1. General Association Between Migraine and WFC
Migraine patients have higher levels of WFC: It was shown that migraine patients have higher WFC scores compared to non-migraine participants. This was particularly notable in the aspect of "strain-based conflict." This suggests that individuals with migraine experience emotional and cognitive burdens that hinder their ability to effectively manage work and family responsibilities.
“Individuals with migraine reported higher levels of both WIF conflict and FIW conflict compared to non-migraine participants. The strongest associations were observed in the strain-based dimensions of WFC, suggesting that individuals with migraine experience emotional and cognitive strain that interferes with their ability to effectively manage work and family responsibilities.”
2.2. Differential Impact of WFC by Gender
Stronger association in men: Surprisingly, the association between migraine and WFC was stronger in men than in women, particularly in the strain-based conflict subdomain.
“A key finding of the present study is the differential impact of migraine on WFC by gender. Men with migraine exhibited a stronger association with WFC than women, particularly in the strain subdomain.”
Challenging traditional assumptions: This finding challenges the traditional assumption that women experience greater WFC as a result of societal expectations regarding caregiving roles.
“These findings challenge traditional assumptions that women experience greater WFC as a result of societal expectations of caregiving roles.”
Relevance of gender role strain theory: The researchers suggest that gender role strain theory may explain this phenomenon. Men experiencing chronic illness may feel inadequate in fulfilling their traditional provider roles, which can lead to work-related strain and an amplification of WFC.
“The gender role strain theory suggests that men who experience chronic illness may struggle with perceived inadequacies in fulfilling their traditional provider roles. This could explain the heightened WFC observed in men with migraine because work-related strain may amplify their feelings of conflict between professional and personal responsibilities.”
2.3. Migraine Severity and WFC
Higher severity leads to increased WFC: It was shown that higher migraine severity (measured by MIDAS scores) leads to increased WFC. This effect becomes more pronounced as the level of disability caused by migraine increases.
“Our study further demonstrates that migraine severity significantly influences WFC. Higher MIDAS were associated with increased WFC, with a particularly pronounced effect in men.”
Stronger impact in men: A stronger association was also observed in men regarding the relationship between severity and WFC.
“Additionally, males exhibit a slightly steeper increase in conflict with rising MIDAS scores compared to females, suggesting a stronger association between migraine severity and WFC among male participants.”
2.4. Employment-related characteristics
Working hours of migraine patients: Migraine patients tended to work longer hours per week compared to non-migraine patients, which was particularly notable in men.
Migraine patients worked longer hours per week (median 40.0 vs. 36.0 hours for females, and 48.0 vs. 42.0 hours for males), and were more likely to work over 42 hours per week (18.2% vs. 7.0% for females and 32.8% vs. 8.7% for males, standardized mean difference= 0.487).
Self-assessment of work-from-home efficiency: Migraine patients rated their work-from-home efficiency higher.
Migraine patients also rated their work-from-home efficiency higher (median 5.50 vs. 4.00 for females and 5.0 vs. 1.0 for males, SMD= 0.556).
2.5. Public Health Relevance
The study highlights the following public health significance:
Migraine is associated with increased work-family conflict, particularly in the strain-based domain, which may lead to occupational stress and reduced well-being.
The impact of migraine on work-life balance is more pronounced in men, highlighting the need for gender-specific workplace interventions.
Since higher migraine severity is associated with higher levels of work-family conflict, effective migraine management may help reduce work-life disruption.
Employers and policymakers should consider implementing flexible work arrangements and mental health support to accommodate employees with migraine.
Addressing work-family conflict in migraine patients may improve productivity, reduce absenteeism, and enhance overall quality of life.
3. Key Methodological Facts
Study Design: A retrospective population-based cohort study based on a cohort of migraine patients in the Negev region of southern Israel (part of the SMILE project).
Participants: 675 migraine patients and 232 non-migraine controls. 80.6% of the migraine patients were female.
Main Exposure: Migraine diagnosis and migraine severity (MIDAS score).
Main Outcome: Work-Family Conflict (WFC). Using the multidimensional WFC tool developed by Carlson et al., two main aspects were evaluated: Work to Family (WIF) and Family to Work (FIW). These were further subdivided into time-based and strain-based conflicts.
Covariates: Sociodemographic characteristics, employment factors, and psychological distress (DASS-21) were adjusted.
Statistical Analysis: Multivariate gamma generalized linear model regression models and quantile regression were used.
Limitations:
Because the study relies on self-reported data, recall bias may occur.
The generalizability of the results is limited because the participant response rate was relatively low at 45%, and the participating cohort consisted of patients with relatively severe migraines (over 50% had moderate to severe disability).
There is a lack of data regarding job types, which may influence the association between migraines and WFC.
4. Conclusion
This study suggests that migraines are significantly associated with WFC, particularly in the strain-based domain. This association was found to be stronger in men, and it was revealed that higher migraine severity leads to increased WFC. These findings highlight the need for strategies to support the work-life balance of migraine patients in both clinical and workplace settings. Interventions such as flexible work arrangements and mental health support may reduce WFC for employees with migraines and improve their productivity and overall well-being.