Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway HØKH Health Services Research, Research Centre, Akershus University Hospital, Lørenskog, Norway Department of Neurology, Oslo University Hospital Ullevål, Oslo, Norway Institute of Clinical Medicine, University of Oslo, Nordbyhagen, Norway.
Pain. 2012 Mar;153(3):682-686. doi: 10.1016/j.pain.2011.12.008. Epub 2012 Jan 24.
Medication overuse headache (MOH) is a chronic headache that is common in the general population. It has characteristics similar to drug dependence, and detoxification is established as the main treatment. The majority of MOH cases are in contact with general practitioners. Our objective was to investigate whether the Severity of Dependence Scale (SDS) score could be used as predictor for the prognosis of MOH in the general population. In a cross-sectional epidemiological survey, an age- and gender-stratified sample of 30,000 persons 30 to 44 years of age was recruited via a posted questionnaire. Those individuals with self-reported chronic headache (≥15 days per month) were interviewed by neurological residents at Akershus University Hospital, Oslo. The International Classification of Headache Disorders was used. Those with MOH were re-interviewed by telephone 2 to 3 years after the initial interview. SDS scores and medication information were collected at baseline and follow-up. The main outcomes were SDS scores, termination of MOH and chronic headache from baseline to follow-up. We found the predominant overused analgesics in this sample to be simple analgesics. At follow-up, 65% of participants no longer had medication overuse, and 37% had changed to episodic headache (<15 days per month). The SDS score at baseline successfully predicted improvement for primary MOH, but not secondary MOH. The SDS scores decreased slightly from baseline to follow-up in those who stopped medication overuse, but were still significantly higher than in subjects with chronic headache without medication overuse at baseline. We conclude that the SDS score can predict successful prognosis related to detoxification of primary MOH but not in secondary MOH.
药物过度使用性头痛（MOH）是一种常见于普通人群的慢性头痛。它具有类似药物依赖的特征，并且戒断被确立为主要治疗方法。大多数 MOH 病例与全科医生有关。我们的目的是研究严重依赖量表（SDS）评分是否可以作为预测普通人群中 MOH 预后的指标。在一项横断面的流行病学调查中，通过邮寄问卷招募了 30000 名年龄在 30 至 44 岁的、按年龄和性别分层的人群。那些自我报告有慢性头痛（每月≥15 天）的人由奥斯陆阿克什胡斯大学医院的神经科住院医师进行访谈。使用了国际头痛疾病分类。那些患有 MOH 的人在初次访谈后 2 至 3 年通过电话再次接受访谈。在基线和随访时收集 SDS 评分和药物信息。主要结果是 SDS 评分、从基线到随访时 MOH 和慢性头痛的终止情况。我们发现，在这个样本中，主要的过度使用的止痛药是简单的止痛药。在随访时，65%的参与者不再过度使用药物，37%的人转为发作性头痛（每月<15 天）。基线时的 SDS 评分成功预测了原发性 MOH 的改善，但不能预测继发性 MOH。在停止过度使用药物的患者中，SDS 评分从基线到随访略有下降，但仍明显高于基线时无药物过度使用的慢性头痛患者。我们得出结论，SDS 评分可以预测原发性 MOH 戒断的成功预后，但不能预测继发性 MOH。
