title: Personality traits in chronic daily headache patients with and without psychiatric comorbidity: an observational study in a tertiary care headache center.
abstract: BACKGROUND
  Previous studies suggest that patients with Chronic Daily Headache (CDH) have higher levels of anxiety and depressive disorders than patients with episodic migraine or tension-type headache. However, no study has considered the presence of psychiatric comorbidity in the analysis of personality traits. The aim of this study is to investigate the prevalence of psychiatric comorbidity and specific personality traits in CDH patients, exploring if specific personality traits are associated to headache itself or to the psychiatric comorbidity associated with headache.
  
  
  METHODS
  An observational, cross-sectional study. Ninety-four CDH patients with and without medication overuse were included in the study and assessed by clinical psychiatric interview and Mini International Neuropsychiatric Interview (M.I.N.I.) as diagnostic tools. Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Hamilton Depression Rating Scale (HAM-D) were afterwards administered. Patients with and without psychiatric comorbidity were compared. Further analyses were made by splitting the whole group according to the headache diagnosis and the presence or not of medication overuse.
  
  
  RESULTS
  Psychiatric comorbidity was detected in 44 patients (46.8%) (group A) and was absent in the remaining 50 patients (53.2%) (group B). Mood and anxiety disorders were the most frequently diagnosed (43.6%).In the overall group, mean scores of MMPI-2 showed a high level in the so-called neurotic triad; in particular the mean score in the Hypochondriasis subscale was in the pathologic area (73.55 ± 13.59), while Depression and Hysteria scores were moderate but not severe (62.53 and 61.61, respectively). In content scales, score in Health Concern was also high (66.73).Group A presented higher scores compared to Group B in the following MMPI-2 subscales: Hypochondriasis (p= .036), Depression (p= .032), Hysteria (p< .0001), Hypomania (p= .030). Group B had a high score only in the Hypochondriasis subscale. No significant differences were found between chronic migraine (CM)-probable CM (pCM) plus probable medication overuse headache (pMOH) and chronic tension-type headache (CTTH)-probable CTTH (pCTTH) plus pMOH patients or between patients with and without drug overuse.
  
  
  CONCLUSIONS
  The so-called "Neurotic Profile" reached clinical level only in CDH patients with psychiatric comorbidity while a high concern about their general health status was a common feature in all CDH patients.
authors.affiliation: Department of Biomedical and Neuromotor Sciences-DIBINEM, University of Bologna - IRCCS Istituto delle Scienze Neurologiche di Bologna, Padiglione G, Ospedale Bellaria, via Altura 3, Bologna, 40139, Italy.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Rausa
authors.forename: Sabina
authors.initials: S
authors.lastname: Cevoli
authors.forename: Elisa
authors.initials: E
authors.lastname: Sancisi
authors.forename: Daniela
authors.initials: D
authors.lastname: Grimaldi
authors.forename: Gabriella
authors.initials: G
authors.lastname: Pollutri
authors.forename: Michela
authors.initials: M
authors.lastname: Casoria
authors.forename: Daniela
authors.initials: D
authors.lastname: Grieco
authors.forename: Alberto
authors.initials: A
authors.lastname: Bisi
authors.forename: Pietro
authors.initials: P
authors.lastname: Cortelli
authors.forename: Euro
authors.initials: E
authors.lastname: Pozzi
authors.forename: Giulia
authors.initials: G
authors.lastname: Pierangeli
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D020773:Headache Disorders / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D010551:Personality; D055815:Young Adult