Headache Unit, C. Mondino National Institute of Neurology Foundation, Italy.
Cephalalgia. 2013 May;33(7):431-43. doi: 10.1177/0333102413477737. Epub 2013 Feb 26.
To evaluate factors associated with a negative outcome in a 3-year follow-up of subjects diagnosed with medication-overuse headache (MOH) (revised-ICHD-II criteria).
All consecutive patients entering the center's inpatient detoxification program were analyzed in a prospective, non-randomized fashion. All participants were assessed by a neurologist using an ad hoc patient record form. Personality was assessed using the Minnesota Multiphasic Personality Inventory (MMPI)-2, Chi-square test, one-way analysis of variance (ANOVA), and odds ratios (OR) were calculated as appropriate.
One-hundred and fifty patients completed the follow-up (79.3% females, age 46.40 ± 11.31 years): 13 never stopped their drug overuse (A), 38 stopped their overuse, but relapsed at least once (B), and 99 stopped and never relapsed (C). The Group A patients differed from those in B + C as they were more frequently single (OR 0.134; P = 0.007) and unemployed (OR 3.273; P = 0.04), took a higher number of drug doses ( P < 0.001), and less frequently drank coffee (OR 3.273; P = 0.044). Personality profile: subjects in A scored higher than those in C on the following scales: Hypochondriasis ( P = 0.007), Depression ( P = 0.003), Paranoia ( P = 0.025), Fears ( P = 0.003), Obsessiveness ( P = 0.026), Bizarre Mentation ( P = 0.046), Social Discomfort ( P = 0.004), Negative Treatment Indicators ( P = 0.040), Repression ( P = 0.007), Overcontrolled Hostility ( P = 0.040), Addiction Admission ( P = 0.021), Social Responsibility ( P = 0.039), and Marital Distress ( P = 0.028).
Disease outcome in MOH patients is influenced negatively by overuse severity and by specific psychological and socio-economic variables. Other possible modifier factors were voluptuary habits.
评估在使用修订后的 ICHD-II 标准诊断药物过度使用性头痛（MOH）的患者进行 3 年随访中与不良结局相关的因素。
所有连续进入中心住院戒毒计划的患者均以前瞻性、非随机的方式进行分析。所有参与者均由神经科医生使用专门的患者记录表进行评估。使用明尼苏达多相人格问卷（MMPI-2）评估人格，使用卡方检验、单因素方差分析（ANOVA）和比值比（OR）进行计算。
150 名患者完成了随访（79.3%为女性，年龄 46.40±11.31 岁）：13 名患者从未停止过药物滥用（A 组），38 名患者停止了药物滥用，但至少复发了一次（B 组），99 名患者停止且从未复发（C 组）。A 组患者与 B+C 组患者不同，他们更频繁地单身（OR 0.134；P=0.007）和失业（OR 3.273；P=0.04），服用的药物剂量更高（P<0.001），喝咖啡的频率更低（OR 3.273；P=0.044）。人格特征：A 组患者在以下量表上的得分高于 C 组：疑病症（P=0.007）、抑郁（P=0.003）、偏执（P=0.025）、恐惧（P=0.003）、强迫观念（P=0.026）、奇异思维（P=0.046）、社交不适（P=0.004）、消极治疗指标（P=0.040）、压抑（P=0.007）、过度控制敌意（P=0.040）、成瘾入院（P=0.021）、社会责任（P=0.039）和婚姻困扰（P=0.028）。
MOH 患者的疾病结局受到药物滥用严重程度以及特定心理和社会经济变量的负面影响。其他可能的修饰因素是享乐习惯。
