Headache Unit, IRCCS C. Mondino Institute of Neurology Foundation, Pavia, Italy.
Headache. 2010 Feb;50(2):198-209. doi: 10.1111/j.1526-4610.2009.01593.x. Epub 2009 Dec 21.
The main aim of this study involves comparing the personality profiles of patients with medication-overuse headache (MOH) and episodic headaches, in order to elucidate the role of personality characteristics, according to one of the most widely used and validated personality assessment tool: Minnesota Multiphasic Personality Inventory (MMPI-2).
Many studies have assessed the personality of headache patients by means of MMPI-2 only using clinical and content scales. In this study the supplementary scales were also used as they evaluate different aspects of personality, particularly broad personality characteristics, generalized emotional distress and behavioral dyscontrol.
We recruited 219 subjects (151 women and 68 men) who were grouped in the following categories: MOH group (n = 82); episodic headache group (n = 82; 58 migraine aura; 6 migraine with aura; 6 frequent episodic tension-type headache; 12 migraine+infrequent episodic tension-type headache) and 1 group of 55 healthy controls. MMPI-2 was employed. Data were computed with one-way anova and post hoc analyses.
Medication-overuse headache and episodic headache patients (EH) showed a very similar pattern, differentiating each other only in the Hypochondriasis (Hs) (P = .007; MOH: mean 14.18 [SD 5.53]; EH: mean 11.93 [SD 5.88] and Health Concerns [HEA]) (P = .005; MOH: mean 14.06 [SD 5.38]; EH: mean 11.81 [SD 5.59]) scales. Surprisingly, no differences were found between the 3 groups in the scales measuring dependence-related behavior such as Addiction Potential Scale (Aps) and Addiction Admission Scale (Aas). MOH and episodic headache patients scored significantly higher in the so-called neurotic scales Hs (P < .0001; MOH: mean 14.18 [SD 5.53]; EH: mean 11.93 [SD 5.88];
mean 5.91 [SD 3.57]), Depression (D) (P < .0001; MOH: mean 26.44 [SD 7.01]; EH: mean 26.09 [SD 5.85];
mean 21.47 [SD 4.90]), and Hysteria (Hy) (P < .0001; MOH: mean 27.33 [SD 5.51]; EH: mean 26.81 [SD 5.68];
mean 21.95 [3.85]) and in many other scales such as Paranoia (Pa), Psychasthenia (Pt), Schizophrenia (Sc) while they scored significantly lower on Ego Strength (Es) and Dominance (Do) scales when compared with controls.
Patients with MOH and episodic headache showed very similar patterns, differentiating only in the Hypochondriasis and Health Concerns scales. Surprisingly, there were no significant differences in the scores of the scales measuring dependence-related behavior. The clinical role of MMPI-2 in discriminating MOH patients with dependency from drugs is discussed, in order to implement a complete tests' battery for headache patients' assessment.
本研究的主要目的是比较药物过度使用性头痛（MOH）和发作性头痛患者的人格特征，以根据最广泛使用和验证的人格评估工具之一明尼苏达多相人格测验（MMPI-2）阐明人格特征的作用。
许多研究仅使用临床和内容量表通过 MMPI-2 评估头痛患者的人格。在这项研究中，还使用了补充量表，因为它们评估了人格的不同方面，特别是广泛的人格特征、普遍的情绪困扰和行为失控。
我们招募了 219 名受试者（151 名女性和 68 名男性），将他们分为以下几类：MOH 组（n=82）；发作性头痛组（n=82；58 例偏头痛先兆；6 例偏头痛伴先兆；6 例频繁发作性紧张型头痛；12 例偏头痛+不频繁发作性紧张型头痛）和 1 组 55 名健康对照者。使用 MMPI-2。使用单因素方差分析和事后分析计算数据。
药物过度使用性头痛和发作性头痛患者（EH）表现出非常相似的模式，仅在疑病症（Hs）（P=0.007；MOH：均值 14.18[SD5.53]；EH：均值 11.93[SD5.88]）和健康问题（HEA）（P=0.005；MOH：均值 14.06[SD5.38]；EH：均值 11.81[SD5.59]）量表上有所不同。令人惊讶的是，在衡量依赖行为的量表，如成瘾潜力量表（Aps）和成瘾入院量表（Aas）上，3 组之间没有差异。MOH 和发作性头痛患者在所谓的神经质量表 Hs（P<0.0001；MOH：均值 14.18[SD5.53]；EH：均值 11.93[SD5.88]；
均值 5.91[SD3.57]）、抑郁（D）（P<0.0001；MOH：均值 26.44[SD7.01]；EH：均值 26.09[SD5.85]；
均值 21.47[SD4.90]）和歇斯底里（Hy）（P<0.0001；MOH：均值 27.33[SD5.51]；EH：均值 26.81[SD5.68]；
均值 21.95[3.85]）方面得分显著较高，并且在许多其他量表，如偏执（Pa）、精神衰弱（Pt）、精神分裂症（Sc）方面得分也显著较高，而在自我力量（Es）和支配（Do）量表上得分显著较低。
MOH 和发作性头痛患者表现出非常相似的模式，仅在疑病症和健康问题量表上有所不同。令人惊讶的是，衡量依赖行为的量表得分没有显著差异。讨论了 MMPI-2 在区分药物依赖的 MOH 患者中的临床作用，以便为头痛患者评估实施完整的测试组合。
