title: Factors associated with a negative outcome of medication-overuse headache: a 3-year follow-up (the 'CARE' protocol).
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Headache Unit, C. Mondino National Institute of Neurology Foundation, Italy.
authors: Grazia
authors: G
authors: Sances
authors: Federica
authors: F
authors: Galli
authors: Natascia
authors: N
authors: Ghiotto
authors: Marta
authors: M
authors: Allena
authors: Elena
authors: E
authors: Guaschino
authors: Alessandra
authors: A
authors: Frustaci
authors: Giuseppe
authors: G
authors: Nappi
authors: Cristina
authors: C
authors: Tassorelli
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D051271:Headache Disorders, Secondary / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008950:MMPI; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D008875:Middle Aged; D010551:Personality; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D000700:Analgesics