The Ruminative Thought Style with Associated Anxiety Influences the Occurrence of Medication-Overuse Headache

Abstract

Background and Purpose To determine the relationships between the ruminative thought style, parameters of psychological distress, and the occurrence of medication-overuse headache (MOH). Methods The study included 164 subjects: 83 patients (11 males and 72 females) who were first diagnosed as MOH, and 81 healthy subjects (22 males and 59 females) as a control group (CG). The study participants were aged 40.2±11.9 years (mean±standard deviation), and they were assessed using the Ruminative Thought Style Questionnaire and Depression Anxiety Stress Scales. Results The degree of rumination was higher in patients with MOH than in the CG ( p <0.001). Among patients with MOH, females, patients with comorbidities, and those who overuse combined analgesic therapy had a higher degree of rumination ( p =0.038, p =0.008, and p =0.015, respectively). In both the MOH patients and CG, the degree of rumination was directly correlated with depression, anxiety, and stress ( r =0.473–0.557, p <0.001, for MOH; r =0.303–0.322, p <0.005, for CG). Rumination and anxiety were associated with MOH [odds ratio (OR)=1.123, 95% confidence interval (CI)=1.071–1.178, p <0.001; OR=1.091, 95% CI=1.005–1.185, p =0.039; respectively]. The analysis of the mediation model showed that the link between rumination and MOH is largely direct (86%), and to a lesser extent is additionally influenced by anxiety as a mediator (14%). Conclusions A ruminative thought style is associated with MOH both directly and via anxiety. Psychological strategies aimed at decreasing ruminative responses and anxiety could be useful in the prevention of MOH in selected patients.

Screening for Depression among Medicyation Overuse Headache Patients and its Treatment could be useful for Improving their Quality of Life

“…The average age of the study subjects was 40.2 ± 11.9 years (min 18, max 71 years). Data in details are described in our previous published paper [15]. All SF-36 scores (PCS, MCS, TS) were statistically significantly lower in MOH compared to the CG (p <0.001).…”

A Descriptive Review of Medication-Overuse Headache: From Pathophysiology to the Comorbidities

“…A follow-up study has observed that central sensitization is Genetic studies suggest the possible importance of polymorphisms in genes relate to the dopaminergic system (DRD4, DRD2, and SLC6A3) and genes involved in th neurobiology of the addiction syndrome (WSF1, BDNF, ACE, and HDAC3) [11] (Figur 1). Central sensitization plays a key role in the pathophysiology of chronic migraine [44 Analysis of somatosensory evoked potentials has shown that patients with chroni Functional neuroimaging studies have shown functional changes in regions involved in nociceptive processes, such as the mesolimbic reward system, the fronto-parietal system, and other regions [53,54]. The mesolimbic system consists of the ventromedial prefrontal cortex, the accumbens region, the substantia nigra, and the ventral tegmental area, which show altered functions in MOH.…”

A Descriptive Review of Medication Overuse HEADACHE-from Pathophysiology to the Clinic

“…Functional neuroimaging studies have shown functional changes in regions involved in nociceptive processes, such as the mesolimbic reward system, the fronto-parietal system, and other regions (53,54). The mesolimbic system consists of the ventromedial prefrontal cortex, the accumbens region, the substantianigra, and the ventral tegmental area, which show altered functions in MOH.…”