Personality traits, depression and migraine in women: a longitudinal study.

Our purpose was to examine the association between personality traits, depression and migraine in the long term. In 56 women with migraine a psychological assessment was carried out to assess the presence of major depression, and the Minnesota Multiphasic Personality Inventory (MMPI) and the State and Trait Anxiety Inventory (STAI) were administered at baseline (T0) and after 6-7 years (T2). Frequency, severity and duration of migraine were recorded at T0, after treatment (T1) and at T2, and their relation to the prevalence of depression and to the MMPI and STAI data was examined (ANOVA, Student's t-test, chi2 analysis, and multiple regression analysis). Pain parameters improved in all patients in T0-T1, but at T2 were higher in patients with depression at T0. The patients whose migraine improved at T2 had, at T0 and T2, significantly lower MMPI and STAI scores. Multiple regression analysis showed a correlation of the MMPI depression score and STAI 1,2 scores at T0 with headache frequency at T2. We conclude that the co-occurrence of migraine, personality changes and depression in women does not appear to influence the results of treatment at short-term, but it seems to be influential on headache history in the long term.

MMPI-2 profiles in chronic daily headache and their relationship to anxiety levels and accompanying symptoms.

OBJECTIVES: To examine a group of patients with chronic daily headache using the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2) and to determine whether the data acquired were related to the anxiety levels of the patients, as detected by the Spielberger State-Trait Anxiety Inventory (STAI) 1, 2 and to the presence of a number of accompanying symptoms that are frequently observed in patients with chronic headache. BACKGROUND: In the last decade, the MMPI-2 was released and its items used to develop 15 "content scales." Recently, this instrument was adapted to the Italian population. METHODS: Five men and 30 women with chronic daily headache had a semistructured interview in which the presence of 21 behavioral or somatic symptoms was recorded. The Italian version of the MMPI-2 and the STAI 1, 2 (Italian version) were employed. A configural analysis of the MMPI profiles was performed, and four types were distinguished: "conversion V" (n = 5), elevation of the "neurotic triad" (n = 5), the "emotionally overwhelmed" with scale elevation of the neurotic triad and of several other scales (n = 18), and "the copers" with no scale elevation above 65 (n = 4). Three patients could not be classified. The pain characteristics, the prevalence of accompanying symptoms, and the STAI 1, 2 scores were assessed in all patients and in the different MMPI groups, and the data were statistically analyzed (ANOVA and chi-square analysis). RESULTS: All patients with no MMPI-2 scale elevation showed a tendency to a conversion V profile: in this group, the chronicity was markedly and significantly lower than in all other groups. Moreover, in this group, the STAI 1, 2 scores and the prevalence of some accompanying symptoms were significantly lower than in the other groups. Migraine characteristics did not differ significantly from group to group. CONCLUSIONS: Hysterical traits were observed in a number of patients with chronic daily headache and might constitute a predisposing factor for this condition. With time, the personality profile deteriorates, either through an increase in the hysterical traits or through its transformation, with a parallel increase in anxiety levels and the presence of accompanying symptoms.

The McGill Pain Questionnaire in patients with TMJ pain and with facial pain as a somatoform disorder.

The purpose of this study was to assess the discriminative capacity of the McGill Pain Questionnaire (MPQ) in patients with temporomandibular joint disorders (TMD) or with facial pain disorder as somatoform disorder (referred to as "atypical facial pain") (FP). The MPQ was administered to 57 TMD and 34 FP patients. Weighted MPQ item scores, subscale Pain Rating Indexes (PRI), and total Pain Rating Index were tested for significant differences (Student's t-test), and the frequency of descriptor choice was also analyzed. Furthermore, the data were processed through two systems based on a counter-propagation neural network: the Self-Organizing Map (SOM) system and a cluster-like analysis. In the FP group eleven MPQ item scores and five PRI scores were significantly higher than those of the TMJ group. There was a considerable difference in descriptor choice between the groups. SOM analysis and cluster-like analysis correctly discriminated 85% or more of the patients. In conclusion, the MPQ showed a consistent discriminative capacity between TMD and FP patients.