Neurological Sciences

, 32:177 | Cite as

Psychopathological profile of patients with chronic migraine and medication overuse: study and findings in 50 cases

  • M. Curone
  • V. Tullo
  • E. Mea
  • A. Proietti-Cecchini
  • C. Peccarisi
  • G. BussoneEmail author
Brief Communication


Patients with chronic migraine (CM) have high frequence of psychiatric comorbidity or psychological distress. The presence of depression, anxiety, panic or obsessive disorders in these patients contributes to poor quality of life and can influence prognosis and treatment. A systematic investigation of psychiatric comorbidity is needed in patients with CM especially in those with medication overuse (MO), in order to reach a more comprehensive clinical management. We assessed the psychological profile of 50 patients, 40 women and 10 men suffering from CM with MO. The Spectrum Project, a complementary way of describing and assessing psychopathology with structured clinical interviews, was used for the psychological evaluation of the patients to explore personality traits. Spectrum instruments mood disorders (MOODS), panic agoraphobic disorders (PAS) and obsessive–compulsive disorder (OBS) were applied to study patients. OBS-questionnaire was positive in 28% of the patients, MOODS-questionnaire in 44%, PAS-questionnaire in 46%. 19 on 50 patients (38%) presented positivity to 2 or to all questionnaires in variable associations. None of the patients of the studied group had complete normal findings in the questionnaires. Clinical records of patients with OBS-questionnaire positivity showed a worse clinical course and tendency to relapse. These results suggest that psychological assessment is an essential step in the evaluation and treatment of patients with CM and MO. The remarkable percentage of OBS-questionnaire positivity in this group indicates that obsessive–compulsive trait represents besides depression and anxiety, a major risk of chronification and overusing.


Chronic migraine with medication overuse Obsessive–compulsive disorder Psychiatric comorbidity Spectrum project 


Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.


  1. 1.
    Swartz KL, Pratt LA, Armenian HK, Lee LC, Eaton WW (2000) Mental disorder and the incidence of migraine headaches in a community sample. Arch Gen Psychiatry 57:945–950PubMedCrossRefGoogle Scholar
  2. 2.
    Breslau N, Davis G (1993) Migraine, physical health and psychiatric disorder: a prospective epidemiologic study in young adults. J Psychiatry Res 2:211–221CrossRefGoogle Scholar
  3. 3.
    Bigal ME, Sheftell FD, Rapoport AM, Tepper SJ, Weeks R, Baskin SM (2003) MMPI personality profiles in patients with primary chronic daily headache: a case-control study. Neurol Sci 24(3):103–110PubMedCrossRefGoogle Scholar
  4. 4.
    Maizels M, Sitherman TA, Penzien DB (2006) A review of screening tools for psychiatric comorbidity in headache patients. Headache 46(suppl 3):98–109CrossRefGoogle Scholar
  5. 5.
    Rucci P, Maser JD (2000) Instrument development in the Italy–USA collaborative spectrum project. Epidemiol Psichiatr Soc 9:249–256PubMedGoogle Scholar
  6. 6.
    Headache Classification Committee of the International Headache Society (2004) The International Classification of Headache Disorders, 2nd edn. Cephalalgia 24 (suppl 1):9–160Google Scholar
  7. 7.
    Fagiolini A, Dell’Osso L, Pini S, Armani A, Bouanani S, Rucci P, Cassano GB, Endicott J, Maser J, Shear MK, Grochocinski VJ, Frank E (1999) Validity and reliability of a new instrument for assessing mood symptomatology: the Structured Clinical Interview for Mood Spectrum (SCI-MOODS). Int J Methods Psychiatr Res 8:71–81CrossRefGoogle Scholar
  8. 8.
    Cassano GB, Frank E, Maser JD, Shear MK, Rotondo A, Mauri M, Dell’Osso L (1999) The panic-agoraphobic spectrum. Hum Psychopharmacol Clin 14:S38–S44CrossRefGoogle Scholar
  9. 9.
    Dell’Osso L, Cassano GB, Sarno N, Millanfranchi A, Pfanner C, Gemignani A, Maser JD, Shear MK, Grochocinski VJ, Rucci P, Frank E (2000) Validity and reliability of the Structured Clinical Interview for Obsessive-Compulsive Spectrum (SCI-OBS) and of the Structured Clinical Interview for Social Phobia Spectrum (SCI-SHY). Int J Methods Psychiatr Res 9:11–24CrossRefGoogle Scholar
  10. 10.
    Luconi R, Bartolini M, Taffi R, Vignini A, Mazzanti L, Provinciali L, Silvestrini M (2007) Prognostic significance of personality profiles in patients with chronic migraine. Headache 47:118–1124CrossRefGoogle Scholar
  11. 11.
    Cupini LM, De Murtas M, Costa C, Mancini M, Eusebi P, Sarchielli P, Calabresi P (2009) Obsessive-compulsive disorder and migraine with medication-overuse headache. Headache 49(7):1005–1013PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • M. Curone
    • 1
  • V. Tullo
    • 1
  • E. Mea
    • 1
  • A. Proietti-Cecchini
    • 1
  • C. Peccarisi
    • 1
  • G. Bussone
    • 1
    Email author
  1. 1.Department of Neurological Sciences, Headache UnitNeurological Institute C. Besta, IRCCS FoundationMilanItaly

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