Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium Department of Neurology, Ghent University Hospital, Ghent, Belgium.
Pain. 2011 Jun;152(6):1334-1339. doi: 10.1016/j.pain.2011.02.014. Epub 2011 Mar 10.
Excessive medication intake is a risk factor for the development of medication-overuse headache (MOH), a condition characterized by an increase of headache frequency to a daily or near-daily pattern. As yet, it is largely unknown why some patients overuse medication. In this study, we examined to what extent attitudes about pain medication, especially perceived need and concerns, and problem-solving are related to MOH. Patients with migraine (n=133) and MOH with a history of migraine (n=42) were recruited from a tertiary headache referral center and completed questionnaires measuring problem-solving and attitudes about pain medication. A problem-solving mode aimed at solving pain was associated with a higher need for and concerns about medication intake. Interestingly, in a model accounting for demographic factors and pain intensity, attempts to control pain, need for medication, and concerns about scrutiny by others because of medication intake all had a unique value in accounting for MOH. Results are discussed in terms of how repeated attempts to solve pain may trigger overuse of medication, even in the presence of clear negative consequences. Repeated attempts at solving pain may increase the need for analgesic medication, despite obvious costs. This mechanism might contribute to the problem of medication-overuse headache.
过度用药是药物过度使用性头痛（MOH）的一个风险因素，MOH 的特征是头痛频率增加到每天或接近每天的模式。然而，为什么有些患者会过度用药，目前还在很大程度上不清楚。在这项研究中，我们研究了对疼痛药物的态度，尤其是对药物的需求和担忧以及解决问题的能力与 MOH 的关系。从一家三级头痛转诊中心招募了偏头痛患者（n=133）和有偏头痛病史的 MOH 患者（n=42），并完成了测量解决问题和对疼痛药物的态度的问卷。旨在解决疼痛的解决问题模式与对药物摄入的更高需求和担忧有关。有趣的是，在一个考虑人口统计学因素和疼痛强度的模型中，控制疼痛的尝试、对药物的需求以及因药物摄入而担心受到他人审查的需求，都对 MOH 的解释具有独特的价值。结果是根据反复尝试解决疼痛可能如何引发过度用药来讨论的，即使存在明显的负面后果也是如此。尽管有明显的代价，但反复尝试解决疼痛可能会增加对止痛药的需求。这种机制可能是药物过度使用性头痛的原因之一。
