MMPI personality profiles in patients with primary chronic daily headache: a case-control study.
We assessed the psychological profile of a large sample of patients with chronic daily headache (CDH) seen in tertiary care. We used a case-control design to study 791 patients who fell into the following categories: ARH group, chronic migraine with analgesic overuse (analgesic rebound headache, ARH), n=399; CM group, chronic migraine (CM) without analgesic overuse, n=158; and new daily persistent headache (NDPH) group, n=69. These groups were compared to two control groups: 1, migraine, n=100; 2, chronic posttraumatic headache (CPTH), n=65. We assessed personality and psychopathology with the Minnesota multiphasic personality inventory (MMPI)-2. The number of patients with Tscores > or =65 and < or =40 were analyzed by the two-sided Fischer's exact test. The ARH and CM groups had a higher number of subjects with T-scores > or =65, when compared to the migraine group, on the following scales: 1 (hypochondrias), 2 (depression), 8 (schizophrenia) and 0 (social introversion). No differences were observed between the NDPH and migraine groups. Considering CPTH as the control group, the pattern we found was quite the opposite of that described above: NDPH group presented a higher number of subjects with T-scores > or =65 on the following scales: 1, 2, 7 (psychasthenia) and 8. ARH and CM groups had significantly higher T-scores for scale 7 alone. NDPH showed T-scores < or =40 in scale 9 when compared to both control groups. We conclude that: (1) psychopathological factors are common in CDH patients, and appear to be a consequence of the chronification process; (2) low scores on scale 9 (hypomania) may relate to the development of NDPH; (3) psychopathological profiles differ among the subgroups of CDH and the MMPI-2 is reliable in identifying such patterns; and (4) psychological assessment is an essential step in the evaluation and treatment of patients with CDH.
Department of Neurology, Albert Einstein College of Medicine, Rousso Building, 1165 Morris Park Avenue, Bronx, NY 10461, USA.
M E
ME
Bigal
F D
FD
Sheftell
A M
AM
Rapoport
S J
SJ
Tepper
R
R
Weeks
S M
SM
Baskin
D000328:Adult; D017668:Age of Onset; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008950:MMPI / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology; D010551:Personality