Abstract
Background/Objectives: Personality traits in patients with cluster headache (CH) remain understudied compared to migraine patients. This could help improve diagnosis, identify comorbidities, and provide more personalized management of CH. This study aimed to characterize the personality profiles of patients with CH and compare them with those of patients with migraine. Methods: This cross-sectional, case-control observational study was conducted at a tertiary hospital's headache unit (May-August 2024). Patients with CH were compared with migraine patients and healthy controls. Demographic and clinical data were collected, and the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) was administered. Results: The study included 28 CH patients (17 with episodic and 11 with chronic CH), 55 migraine patients (34 with episodic migraine and 21 with chronic migraine), and 54 healthy controls. Both patient groups reported significantly more somatic and cognitive complaints than controls (p < 0.05). Compared to controls, the migraine group exhibited greater emotional dysfunction, social avoidance, demoralization, introversion, and social anxiety (p < 0.05), while the CH group showed greater impulsivity (p < 0.05). Directly comparing patient groups, migraine patients displayed greater social avoidance, emotional dysfunction, demoralization, and introversion than the CH group (p < 0.05). CH patients also showed a non-significant trend towards behavioral disinhibition, hypomania, a favorable self-image, juvenile conduct problems, substance abuse, and aggressiveness. Patients with CH did not present a higher risk of suicide compared to migraine patients. Conclusions: This study identified distinct personality profiles: Migraine patients exhibited greater emotional and interpersonal dysfunction (internal distress and withdrawal), while CH patients exhibited greater externalizing behavioral dysfunction, predominantly involving impulsivity.