• S Bottiroli, M Viana, G Sances, N Ghiotto, E Guaschino, F Galli, E Vegni, S Pazzi, G Nappi, and C Tassorelli.
• Headache Science Center and Headache Unit, National Neurological Institute C. Mondino, Pavia, Italy sara.bottiroli@mondino.it.
• Cephalalgia. 2016 Dec 1; 36 (14): 1356-1365.

AimThe 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.MethodsAll 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. χ(2) tests, one-way analyses of variance, and odds ratios (ORs) were used.ResultsA 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).ConclusionsThe outcome of detoxification is influenced by psychological factors that should be considered when considering treatment strategies.© International Headache Society 2016.

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