title: Cephalalgiaphobia as a feature of high-frequency migraine: a pilot study.
abstract: BACKGROUND
  Cephalalgiaphobia is the fear of having a headache attack during a pain-free period that may induce patients to use analgesic in the absence of pain to prevent headache and to improve their performances. This study aims at assessing if cephalalgiaphobia is related to migraine frequency or medication overuse, and if it is per se a predictor of increase in migraine frequency.
  
  
  METHODS
  This is a pilot prospective cohort study on 126 consecutive migraineurs referred to a tertiary Headache Centre. A headache specialist collected data regarding migraine features, frequency and medications at baseline (T0) and 2 years later (T1). Cephalalgiaphobia was investigated at T0 and T1 through a score determined by a 4 items questionnaire.
  
  
  RESULTS
  Moderate-high migraine frequency was associated with higher risk of cephalalgiaphobia (p < 0.001). Chronic migraineurs with medication overuse had higher score of cephalalgiaphobia than those without medication overuse (p < 0.001). Patients with increased migraine frequency between T0 and T1 had higher cephalalgiaphobia score (p < 0.001).
  
  
  CONCLUSIONS
  Cephalalgiaphobia may represent a high-frequency migraine feature and may play a role in chronicization. Therefore, it should be better investigated by clinicians and treated or prevented in order to reduce the risk of disability and the increase in migraine frequency.
authors.forename: Giulia
authors.initials: G
authors.lastname: Giannini
authors.forename: Stefano
authors.initials: S
authors.lastname: Zanigni
authors.forename: Daniela
authors.initials: D
authors.lastname: Grimaldi
authors.forename: Roberto
authors.initials: R
authors.lastname: Melotti
authors.forename: Giulia
authors.initials: G
authors.lastname: Pierangeli
authors.forename: Pietro
authors.initials: P
authors.lastname: Cortelli
authors.forename: Sabina
authors.initials: S
authors.lastname: Cevoli
mesh_terms: D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D002908:Chronic Disease / Q000523:psychology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000517:prevention & control* / Q000523:psychology*; D010698:Phobic Disorders / Q000523:psychology*; D010865:Pilot Projects; D011446:Prospective Studies; D012651:Self Medication / Q000523:psychology*
chemical_list: D000700:Analgesics