title: Approaches to treatments of chronic migraine associated with medication overuse: a comparison between different intensity regimens.
abstract: Treatment of chronic migraine with medication overuse requires withdrawal from acute medications. However, guidelines and clear indications for different intensity regimens, i.e., day hospital (DH) vs. inpatient treatment, are not available. Patients completed disability, quality of life (QoL) and depression questionnaires; headaches frequency and overused medications category were collected. Mann-Whitney U test and Chi square were used to assess differences between inpatients and DH patients; Bonferroni correction was applied. 194 patients aged 43.9 ± 12 (160 females) were enrolled (100 from DH, 94 inpatients). Inpatients were older, less educated and with lower employment rates. Inpatients had higher MIDAS scores (P = 0.003) and headache frequency (P = 0.002). They had lower QoL for restrictive (P = 0.002) and preventive components; no difference was found for disability, mood state and QoL emotional component. Patients treated during hospitalization had higher disease severity and lower quality of life, but similar disability and mood state than those treated in DH.
authors.affiliation: Neurology, Public Health and Disability Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy, araggi@istituto-besta.it.
authors.forename: A
authors.initials: A
authors.lastname: Raggi
authors.forename: S
authors.initials: S
authors.lastname: Schiavolin
authors.forename: M
authors.initials: M
authors.lastname: Leonardi
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: D
authors.initials: D
authors.lastname: D'Amico
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000453:epidemiology*; D000067490:Prescription Drug Overuse; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires