title: Psychological factors associated with failure of detoxification treatment in chronic headache associated with medication overuse.
abstract: OBJECTIVE
  The aim of this study was to evaluate the psychological factors associated with a negative outcome following detoxification in a 2-month follow-up in medication-overuse headache.
  
  
  METHODS
  All consecutive patients entering the detoxification program were analysed in a prospective, non-randomised fashion. Psychiatric conditions and personality characteristics were assessed using the Structured Clinical Interview for DSM-IV Disorders (SCID-I) and the Minnesota Multiphasic Personality Inventory (MMPI)-2. χ2tests, one-way analyses of variance, and odds ratios (ORs) were used.
  
  
  RESULTS
  A total of 248 patients completed the follow-up: 156 stopped overuse and their headaches reverted to an episodic pattern (Group A); 23 kept overusing without any benefit on headache frequency (Group B); and 51 stopped overuse without any benefit on headache frequency (Group C). The prognostic factors for the outcome of Group B were higher scores on the correction (OR 1.128; p = 0.036), depression (OR 1.071; p = 0.05), hysteria (OR 1.106; p = 0.023), and overcontrolled hostility (OR 1.182; p = 0.04) MMPI-2 scales, whereas those for Group C were psychiatric comorbidities (OR 1.502; p = 0.021) and higher scores on the hysteria scale (OR 1.125; p = 0.004).
  
  
  CONCLUSIONS
  The outcome of detoxification is influenced by psychological factors that should be considered when considering treatment strategies.
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy sara.bottiroli@mondino.it.
authors.forename: S
authors.initials: S
authors.lastname: Bottiroli
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Viana
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sances
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Ghiotto
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Guaschino
authors.affiliation: Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Galli
authors.affiliation: Department of Health Sciences, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vegni
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pazzi
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Nappi
authors.affiliation: Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy.|Department of Brain and Behavioral Science, University of Pavia, Pavia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Tassorelli
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D020773:Headache Disorders / Q000523:psychology* / Q000628:therapy*; D051271:Headache Disorders, Secondary / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067490:Prescription Drug Overuse / Q000523:psychology*; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: Medication-overuse headache; detoxification failure; follow-up; personality; psychological factors