title: Psychopathological comorbidities in medication-overuse headache: a multicentre clinical study.
abstract: OBJECTIVE
  In medication-overuse headache (MOH) patients, the presence of psychopathological disturbances may be a predictor of relapse and poor response to treatment. This multicentre study aimed to assess the occurrence of psychopathological disorders in MOH patients by comparing the incidence of psychopathological disturbances with episodic migraine (EM) patients and healthy controls (HC).
  
  
  METHODS
  The psychopathological assessment of patients and HC involved the administrations of the Beck Depression Inventory, the Beck Anxiety Inventory, the Modified Mini International Neuropsychiatric Interview (M-MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Leeds Dependence Questionnaire.
  
  
  RESULTS
  The MOH, EM and HC groups (88, 129 and 102 subjects, respectively) differed significantly from each other for the presence of moderate/severe anxiety, whereas mood disorder and depression were revealed in similar proportions for both MOH and EM patients. By stratifying the M-MINI questionnaire results according to the number of psychiatric disorders, it was found that MOH patients had a more complex profile of psychiatric comorbidity. Furthermore, clinically relevant obsessive-compulsive disturbances for abused drugs assessed by Y-BOCS appeared to be more represented in the MOH group, whilst the prevalence of this trait in the EM group was comparable to that of HC (12.5%, 0.8% and 0%, respectively).
  
  
  CONCLUSIONS
  Our study indicates the multiple presence of psychopathological comorbidities in patients with MOH. In light of this, it is recommended that the assessment of the psychopathological profile be included in an evaluation of MOH patients, allowing the clinician to more rapidly start an appropriate behavioural treatment, which would greatly improve MOH management.
authors.affiliation: Clinica Neurologica, Azienda Ospedaliero - Universitaria di Perugia, Perugia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Sarchielli
authors.affiliation: Clinica Neurologica, Azienda Ospedaliero - Universitaria di Perugia, Perugia, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Corbelli
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Messina
authors.affiliation: Centro Cefalee e Malattie Cerebrovascolari, Ospedale S. Eugenio, Rome, Italy.
authors.forename: L M
authors.initials: LM
authors.lastname: Cupini
authors.affiliation: Clinica Neurologica, Policlinico TorVergata, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bernardi
authors.affiliation: UCADH-Varese, Department Biotechnology and Life Sciences University of Insubria-Varese, Varese, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bono
authors.affiliation: Dipartimento di Neurologia e Psichiatria, 'Sapienza' Università di Roma, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Di Piero
authors.affiliation: Dipartimento di Neurologia e Psichiatria, 'Sapienza' Università di Roma, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Petolicchio
authors.affiliation: Clinica Neurologica, Policlinico di Bari, Bari, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Livrea
authors.affiliation: Clinica Neurologica, Policlinico di Bari, Bari, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Prudenzano
authors.affiliation: Centro Cefalee, Università degli Studi di Modena e Reggio Emilia, Modena, Italy.
authors.forename: L A
authors.initials: LA
authors.lastname: Pini
authors.affiliation: Department of Brain and Behavioural Sciences, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sandrini
authors.affiliation: Department of Brain and Behavioural Sciences, C. Mondino National Neurological Institute, University of Pavia, Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Allena
authors.affiliation: Clinica Neurologica, II Università degli Studi di Napoli, Napoli, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Tedeschi
authors.affiliation: Clinica Neurologica, II Università degli Studi di Napoli, Napoli, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Russo
authors.affiliation: Clinica Neurologica, Azienda Ospedaliero - Universitaria di Perugia, Perugia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Caproni
authors.affiliation: IRCCS-Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Beghi
authors.affiliation: Clinica Neurologica, Azienda Ospedaliero - Universitaria di Perugia, Perugia, Italy.|IRCCS Fondazione 'S. Lucia', Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Calabresi
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D051271:Headache Disorders, Secondary / Q000453:epidemiology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D015995:Prevalence
keywords: case-control studies; headache; medication-overuse headache; migraine; obsessive−compulsive disturbances; psychiatric disorders