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The Journal of Headache and Pain

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Open Access 01-12-2013 | Short report

Psychological and neuropsychological correlates of dependence-related behaviour in Medication Overuse Headaches: a one year follow-up study

Authors: Françoise Radat, Sandra Chanraud, Georges Di Scala, Virginie Dousset, Michèle Allard

Published in: The Journal of Headache and Pain | Issue 1/2013

Abstract

Background

Medication Overuse Headache (MOH) can be related in some patients to dependence-related behaviour characterised by craving, a deficit in controlling substance intake, which is associated to orbitofrontal cortex (OFC) dysfunction. The aim of this study was to explore the psychological correlates in MOH patients and the functioning of the OFC through neuropsychological assessment (Iowa Gambling Task: IGT) and to relate it to prognosis at a one year follow-up point.

Findings

Seventeen subjects suffering from probable MOH were included and compared to 19 migraineurs and to 17 controls. The results show significant between group differences for behavioural dependence, depression, anxiety, catastrophizing. There were no between group differences for impulsivity. Mean IGT score did not allow differentiation of MOH patients from the other groups, whereas the score was significantly different between opiate abusers and other medication abusers (45 +/−5.7 versus 57.1 +/−8.2, p = 0.019). Among the clinical variables rated at inclusion, the amount of acute headache medication taken per month was the only one predicting the prognosis (RR = 1.05, 95% CI = 1-1.06, p = 0.04). A slight increase in risk of relapse at 1 year was observed in patients with poorer IGT scores (RR = 0.92, 95% CI = 0.85-1, p = 0.05) and higher behavioural-dependence scores (RR = 1.07, 95% CI = 1–1.14, p = 0.05). None of the other psychological variables predicted relapse risk.

Conclusions

These results must be interpreted with caution due to the low number of subjects. They showed a deficit in decision making processes in MOH patients who overuse medications containing psychoactive substances like opiates. Moreover dependence-related variables are related to the prognosis.

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Title: Psychological and neuropsychological correlates of dependence-related behaviour in Medication Overuse Headaches: a one year follow-up study
Authors: Françoise Radat
Sandra Chanraud
Georges Di Scala
Virginie Dousset
Michèle Allard
Publication date: 01-12-2013
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2013
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/1129-2377-14-59

At a glance: The STEP trials

Springer Medicine

Psychological and neuropsychological correlates of dependence-related behaviour in Medication Overuse Headaches: a one year follow-up study

Abstract

Background

Findings

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Findings

Conclusions

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