title: A 14-month study of change in disability and mood state in patients with chronic migraine associated to medication overuse.
abstract: This paper aims to evaluate changes in disease severity, disability and mood state in patients with chronic migraine associated to medication overuse (CM-MO). MIDAS was used for assessing disease activity, WHO-DAS-2 for disability, DBI-2 for mood state. ANOVA was used to test change over time; t-test to assess follow-up differences in WHO-DAS-2 and BDI-2 between patients with MIDAS ≤20 and ≥21. Change in MIDAS, WHO-DAS-2 and BDI-2 scores were computed: Pearson's index was used to assess correlation between them; linear regression to assess change in WHO-DAS-2, using MIDAS and BDI-2 change as predictors. Mean MIDAS decreased significantly (from 101.9 to 52.0). In 26.1 % of the sample, MIDAS fell below 21 at follow-up: these patients had lower WHO-DAS-2 score. WHO-DAS-2 change was little correlated to MIDAS change and strongly correlated to changes in BDI-2 scores. 57.1 % of WHO-DAS-2 change variance is explained by change in BDI-2 and MIDAS scores. There was a clear clinical improvement 14 months after detoxification, and a modest reduction in disability which is explained by reduced disease activity and improved mood state. An appropriate treatment of CM-MO, based on detoxification and prophylaxis, is likely to reduce disease burden: recognition and treatment of mood problems may be a key factor to reduce disability.
authors.affiliation: Neurology Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133 Milan, Italy. araggi@istituto-besta.it
authors.forename: A
authors.initials: A
authors.lastname: Raggi
authors.forename: M
authors.initials: M
authors.lastname: Leonardi
authors.forename: A M
authors.initials: AM
authors.lastname: Giovannetti
authors.forename: S
authors.initials: S
authors.lastname: Schiavolin
authors.forename: G
authors.initials: G
authors.lastname: Bussone
authors.forename: L
authors.initials: L
authors.lastname: Grazzi
authors.forename: S
authors.initials: S
authors.lastname: Usai
authors.forename: M
authors.initials: M
authors.lastname: Curone
authors.forename: P
authors.initials: P
authors.lastname: Di Fiore
authors.forename: D
authors.initials: D
authors.lastname: D'Amico
mesh_terms: D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology
chemical_list: D000700:Analgesics