{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T17:54:39Z","timestamp":1771523679691,"version":"3.50.1"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic migraine (CM), especially when complicated by medication overuse headache (MOH), frequently coexists with psychiatric and somatic comorbidities that challenge conventional monodisciplinary management. Integrated, interdisciplinary care has been proposed as a solution, but real-world implementation remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate and compare the diagnostic reasoning, treatment preferences, and follow-up strategies among neurologists, psychiatrists, and family physicians when managing a complex case of CM with comorbidities and medication overuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A case-based, multidisciplinary study was conducted using a structured vignette of a middle-aged woman with CM\u202f+\u202fMOH and multiple comorbidities. Ten questions were asked for each specialty (neurologists, psychiatrists, and family physicians) across T\u00fcrkiye. Responses from 305 clinicians were analyzed via inductive thematic analysis and domain-specific agreement metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Neurologists prioritized headache semiology and pharmacological treatment; psychiatrists emphasized psychosocial burdens and behavioral interventions; and family physicians reported heterogeneous decision-making shaped by system-level constraints. Agreement levels varied by discipline and clinical domain. The level of awareness of multimorbidity was high, yet interdisciplinary coordination was limited. Across groups, common barriers included stigma, poor treatment adherence, and unclear referral pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CM\u202f+\u202fMOH patients with multimorbidity constitute a clinically complex population requiring interdisciplinary collaboration. The differences in approach highlight the need for structured care pathways and shared decision-making frameworks. Family physicians can act as pivotal coordinators if supported by headache-specific training and referral networks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1646114","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T04:12:40Z","timestamp":1757909560000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Discipline-specific responses to a complex migraine case: a vignette-based survey among neurologists, psychiatrists, and family physicians"],"prefix":"10.3389","volume":"16","author":[{"given":"Rah\u015fan","family":"Karac\u0131","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esra","family":"Ayd\u0131n S\u00fcnb\u00fcl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nil","family":"Tekin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahar","family":"Ta\u015fdelen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikbal Humay","family":"Arman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00fcsun","family":"Mayda Doma\u00e7","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aynur","family":"\u00d6zge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1111\/head.13342","article-title":"Identifying natural subgroups of migraine based on comorbidity and concomitant condition profiles: results of the chronic migraine epidemiology and outcomes (CaMEO) study","volume":"58","author":"Lipton","year":"2018","journal-title":"Headache"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1186\/s10194-021-01281-z","article-title":"Comorbidities of primary headache disorders: a literature review with meta-analysis","volume":"22","author":"Caponnetto","year":"2021","journal-title":"J Headache Pain"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e2224","DOI":"10.1212\/WNL.0000000000008589","article-title":"Migraine progression in subgroups of migraine based on comorbidities: results of the CaMEO study","volume":"93","author":"Lipton","year":"2019","journal-title":"Neurology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/head.12979","article-title":"Predictors of 12-months relapse after withdrawal treatment in hospitalized patients with chronic 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cases","volume":"12","author":"\u00d6zge","year":"2023","journal-title":"J Clin Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1002\/jhm.70117","article-title":"Exploring professional experiences and career insights: a survey of pediatric hospitalists","volume":"2025","author":"Kim","year":"2025","journal-title":"J Hosp Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1111\/ane.13014","article-title":"Multimorbidity in patients with chronic migraine and medication overuse headache","volume":"138","author":"D'Amico","year":"2018","journal-title":"Acta Neurol Scand"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1111\/ene.14034","article-title":"The cost and the value of treatment of medication overuse headache in Italy: a longitudinal study based on patient-derived data","volume":"27","author":"Raggi","year":"2020","journal-title":"Eur J Neurol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1111\/head.13385","article-title":"A qualitative study on patients with chronic migraine with medication overuse headache: comparing frequent and non-frequent Relapsers","volume":"58","author":"Scaratti","year":"2018","journal-title":"Headache"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s10072-017-2894-9","article-title":"Clinical and psychosocial features of frequent relapsers (FR) among patients with chronic migraine and medication overuse","volume":"38","author":"Raggi","year":"2017","journal-title":"Neurol Sci"}],"container-title":["Frontiers in 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