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Bottiroli S, Greco R, Franco V, Zanaboni A, Palmisani M, Vaghi G, Sances G, De Icco R, Tassorelli C. Peripheral Endocannabinoid Components and Lipid Plasma Levels in Patients with Resistant Migraine and Co-Morbid Personality and Psychological Disorders: A Cross-Sectional Study. Int J Mol Sci 2024; 25:1893. [PMID: 38339171 PMCID: PMC10855606 DOI: 10.3390/ijms25031893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Resistant migraine characterizes those patients who have failed at least three classes of migraine prophylaxis. These difficult-to-treat patients are likely to be characterized by a high prevalence of psychological disturbances. A dysfunction of the endocannabinoid system (ECS), including alteration in the levels of endocannabinoid congeners, may underlie several psychiatric disorders and the pathogenesis of migraines. Here we explored whether the peripheral gene expression of major components of the ECS and the plasma levels of endocannabinoids and related lipids are associated with psychological disorders in resistant migraine. Fifty-one patients (age = 46.0 ± 11.7) with resistant migraine received a comprehensive psychological evaluation according to the DSM-5 criteria. Among the patients, 61% had personality disorders (PD) and 61% had mood disorders (MD). Several associations were found between these psychological disorders and peripheral ECS alterations. Lower plasma levels of palmitoiletanolamide (PEA) were found in the PD group compared with the non-PD group. The MD group was characterized by lower mRNA levels of diacylglycerol lipase α (DAGLα) and CB2 (cannabinoid-2) receptor. The results suggest the existence of peripheral dysfunction in some components of the ECS and an alteration in plasma levels of PEA in patients with resistant migraine and mood or personality disorders.
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Affiliation(s)
- Sara Bottiroli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (S.B.); (A.Z.); (G.V.); (R.D.I.); (C.T.)
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
| | - Rosaria Greco
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
| | - Valentina Franco
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
- Clinical and Experimental Pharmacology Unit, Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Annamaria Zanaboni
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (S.B.); (A.Z.); (G.V.); (R.D.I.); (C.T.)
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
| | - Michela Palmisani
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
- Clinical and Experimental Pharmacology Unit, Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Gloria Vaghi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (S.B.); (A.Z.); (G.V.); (R.D.I.); (C.T.)
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
| | - Grazia Sances
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
| | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (S.B.); (A.Z.); (G.V.); (R.D.I.); (C.T.)
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (S.B.); (A.Z.); (G.V.); (R.D.I.); (C.T.)
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, 27100 Pavia, Italy; (V.F.); (M.P.); (G.S.)
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Soman S, Nair R. Passive aggressive personality disorder - Need we bade goodbye? Asian J Psychiatr 2024; 91:103862. [PMID: 38103475 DOI: 10.1016/j.ajp.2023.103862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/19/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Savitha Soman
- Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India.
| | - Rajesh Nair
- Sanjivani Multi-speciality Hospital, Kollakadavu, Chengannur, Kerala, India
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Golovacheva VA, Golovacheva AA, Romanov DV, Volodarskaya EA. [Mental disorders, social and demographic characteristics of patients with chronic and episodic migraine]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:94-101. [PMID: 38261290 DOI: 10.17116/jnevro202412401194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
OBJECTIVE To compare socio-demographic, clinical and psychological characteristics and comorbid mental disorders in patients with chronic migraine (CM) and episodic migraine (EM). MATERIAL AND METHODS Eighty patients with migraine (40 with CM (16 men and 24 women, mean age 33.5±6.1 years) and 40 with EM (9 men and 31 women, mean age 31.4±5.7 years) were examined. All patients were interviewed and tested with psychometric methods. Socio-demographic and clinical-psychological characteristics were determined in all patients. The psychiatrist assessed the mental status of patients and diagnosed comorbid mental disorders according to the ICD-10 criteria. RESULTS Symptoms of depression, high levels of trait and state anxiety, and a tendency to emotional inadequacy of response were more common in CM patients than in EM patients (p<0.05). Mental disorders, predominantly of the anxiety-depressive spectrum, were more common in CM patients than EM patients (OR (95% CI)=2.54 (2.03 to 2.98, p<0.001). Seventy-five percent of CM patients had more than one psychiatric diagnosis, almost a quarter of CM patients had schizotypal disorder, which is significantly higher than in EM patients (OR (95% CI)=1.99; 1.03 to 2.42, p<0.001). There were more unmarried, single (without constant partner), unemployed, high-education patients in the CM group than in the EM group. The negative impact of headache on the daily activity of patients was significantly higher in the CM group than in the EM group (p<0.05). CONCLUSION Mental disorders and psychological features (anxiety, depression symptoms, a tendency to emotional inadequacy of response) are more common in CM patients than in EM patients. The presence of these factors may contribute to the chronification of migraine.
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Affiliation(s)
- V A Golovacheva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A A Golovacheva
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - D V Romanov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Mental Health Research Center, Moscow, Russia
| | - E A Volodarskaya
- Vavilov Institute for the History of Science and Technology, Moscow, Russia
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Bottiroli S, Renzi A, Ballante E, De Icco R, Sances G, Tanzilli A, Vecchi T, Tassorelli C, Galli F. Personality in Chronic Headache: A Systematic Review with Meta-Analysis. Pain Res Manag 2023; 2023:6685372. [PMID: 37671122 PMCID: PMC10477030 DOI: 10.1155/2023/6685372] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/21/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023]
Abstract
Background Chronic headache (CH) is a condition that includes different subtypes of headaches and that can impair different life domains. Personality traits can play a relevant role both in the development and in coping with this medical condition. The first aim of the present study is to realize a systematic review of the personality traits associated with CH compared to healthy controls; the second objective is to carry out a quantitative meta-analysis with the studies using the same instrument to assess personality traits. Method The literature search encompassed articles published from 1988 until December 2022 on the major databases in the field of health and social sciences: PubMed, Scopus, PsychInfo, and Web of Science. Results Thirteen studies were included in the systematic review, but only three studies were deeply explored in a meta-analysis since the only ones used a common instrument for personality assessment (Minnesota Multiphasic Personality Inventory). According to the meta-analysis, different subtypes of CH patients scored higher than healthy controls on Hypochondriasis and Hysteria Scales. The systematic review showed higher levels of depressive and anxious personality dimensions and pain catastrophizing in CH compared to healthy controls. Moreover, frequent-chronic forms and medication-overuse headache were the most symptomatic and frail categories showing higher levels of dysfunctional personality traits and psychopathological symptoms. Conclusions These results seem to confirm a "neurotic profile" in patients suffering from CH. The identification of the main personality traits involved in the onset and maintenance of headache disorders represents an important objective for developing psychological interventions.
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Affiliation(s)
- Sara Bottiroli
- Giustino Fortunato University, Benevento, Italy
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Elena Ballante
- BioData Science Unit, IRCCS C. Mondino Foundation, Pavia, Italy
- Department of Political and Social Sciences, University of Pavia, Italy
| | - Roberto De Icco
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Grazia Sances
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
| | - Annalisa Tanzilli
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
| | - Tomaso Vecchi
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Centre, IRCCS C. Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Federica Galli
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Rome, Italy
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Boni M, Ciaramella A. Role of Personality and Psychiatric Disorders in the Perception of Pain. Psychiatr Q 2023:10.1007/s11126-023-10026-x. [PMID: 37266830 DOI: 10.1007/s11126-023-10026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/03/2023]
Abstract
Although previous studies have shown that psychiatric and personality disorders are more prevalent in chronic pain than in pain-free groups, few studies have investigated the prevalence of personality disorders (PerDs) in patients with chronic pain with and without a psychiatric comorbidity. The aim of the present study was therefore designed to investigate the burden of PerDs on the prevalence and perception of chronic pain in patients with and without psychiatric comorbidity. 232 patients from the Gift Institute for Integrative Medicine in Pisa, Italy, of which n = 161 (69.4%) were patients with chronic pain, were administered the SCID II for personality disorders and MINI for DSM IV-TR criteria. Both psychiatric and personality disorders were more prevalent in the chronic pain group than in the pain-free group (χ2 = 5.9, p = .015, φ = .16; χ2 = 7.2, p = .007, φ = .18). Cluster A and C PerDs were more prevalent in patients with chronic pain than in subjects without pain (χ2 = 8.1, p = .004, φ = .19; χ2 = 4.7, p = .030, φ = .14, respectively). Unlike Cluster C PerDs, however, Cluster A PerDs were more prevalent in the absence of psychiatric comorbidity (χ2 = 5.0, p = .024, φ = .29), and by themselves worsened the pain perceived. An appropriate PerD diagnosis can be helpful in the treatment of patients with chronic pain.
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Affiliation(s)
- Melania Boni
- Education Programme Partner, Aplysia APS, University of Pisa, Florence, Italy.
| | - Antonella Ciaramella
- Education Programme Partner, Aplysia APS, University of Pisa, Florence, Italy
- GIFT Institute of Integrative Medicine, Pisa, Italy
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Clemente MJ, Martins Silva AS, Pozzolo Pedro MO, Paiva HS, de Azevedo Marques Périco C, Torales J, Ventriglio A, Castaldelli-Maia JM. A meta-analysis and meta-regression analysis of the global prevalence of obsessive-compulsive personality disorder. Heliyon 2022; 8:e09912. [PMID: 35865977 PMCID: PMC9294057 DOI: 10.1016/j.heliyon.2022.e09912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/02/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
There is a relative dearth of research on Obsessive-Compulsive Personality Disorder (OCPD), even if it has been recognized for over 100 years. Thus, the present study aims to review the worldwide prevalence of OCPD in different populations. The search was conducted employing the PubMed database of the US National Library of Medicine and Biblioteca Virtual em Saúde (BVS) to detect available studies showing OCPD prevalence rates. All the prevalence rates were extracted and aggregated through random-effects models. Meta-regression and sensitivity analyses were performed. The final sample was composed of 46 articles, including 89,264 individuals. We found that OCPD reports a high prevalence rate, with 6.5% (95%CI = 4.3–9.1%), and reaching even higher among psychiatric and clinical patient population. OCPD has presented stable prevalence rates worldwide throughout the past 28 years. There was no gender-related effect, but OCPD prevalence rates may decrease with age increase. There is a need to investigate personality disorders epidemiology based on the recently updated classification systems (i.e., DSM-5 and ICD-11). The present meta-analysis may suggest that the current diagnostic tools may detect OCPD in a cross-sectional assessment but not throughout the life of the person. OCPD rates do not vary significantly around the globe, with a prevalence of 6.5%. Higher rates were found in psychiatric and clinical patients’ population. OCPD prevalence has been stable throughout the past 28 years. There was no genre-related effect but it may decrease with age increase. The current diagnostic instruments may detect OCPD but may not concisely and adequately evaluate its clinical impact.
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Affiliation(s)
| | - Anderson Sousa Martins Silva
- Health Secretariat of São Bernardo do Campo, São Bernardo do Campo, SP, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | | | - Henrique Soares Paiva
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Cintia de Azevedo Marques Périco
- Health Secretariat of São Bernardo do Campo, São Bernardo do Campo, SP, Brazil.,Department of Neuroscience, Medical School, ABC Health University Center, Santo André, SP, Brazil
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - João Maurício Castaldelli-Maia
- Health Secretariat of São Bernardo do Campo, São Bernardo do Campo, SP, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil.,Department of Neuroscience, Medical School, ABC Health University Center, Santo André, SP, Brazil.,Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
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7
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Bottiroli S, De Icco R, Vaghi G, Pazzi S, Guaschino E, Allena M, Ghiotto N, Martinelli D, Tassorelli C, Sances G. Psychological predictors of negative treatment outcome with Erenumab in chronic migraine: data from an open label long-term prospective study. J Headache Pain 2021; 22:114. [PMID: 34600468 PMCID: PMC8487575 DOI: 10.1186/s10194-021-01333-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/22/2021] [Indexed: 12/23/2022] Open
Abstract
Background Monoclonal antibodies (mABs) targeting the calcitonin gene-related peptide (CGRP) pathway represent the first disease-specific preventive migraine therapy. Growing evidence suggests that they are effective in the preventive treatment of difficult-to-treat patients. In this study, we evaluated the psychological predictors of the outcome of treatment with the anti-CGRP monoclonal antibody erenumab in patients with chronic migraine (CM). Methods Seventy-five patients with CM who had already failed at least 3 preventive therapies received erenumab every 28 days for a period of 12 months. Before the first administration, patients received a full psychological evaluation using The Structured Clinical Interview for DSM-5 Clinician Version (SCID-5-CV) to assess personality disturbances (primary outcome), mood and anxiety disorders, and as well specific questionnaires to evaluate alexithymia traits, childhood traumas, and current stressors (secondary outcomes). Results After 12 months of treatment, 53 patients reported a reduction of at least 50% in headache days/per month (Responders), whereas 22 did not (Non Responders). When compared to Responders, Non Responders were characterized by a higher prevalence of personality disorders belonging to Cluster C (avoidant, dependent, and obsessive-compulsive) (77% vs 37%, p = .001). Non Responders were also characterized by a higher prevalence of anxiety disorders (90% vs 60%, p = 0.007), showed more alexithymic traits (51.7 ± 13.7 vs 42.9 ± 14.3, p = 0.017), and reported a higher number of 'at least serious' current stressors (3.2 ± 4.0 vs 0.8 ± 1.4, p < .0001) than Responders. At the multivariate analysis, higher prevalence of Cluster C personality disorders (OR 3.697; p = 0.05) and higher number of ‘at least serious’ life events (OR 1.382; p = 0.017) arose as prognostic factors of erenumab failure. Conclusions Erenumab confirmed its effectiveness in a population of difficult-to-treat migraine. The presence of “anxious-fearful” personality together with current stressors and anxiety represent negative predictors of treatment outcome. Trial registration The study protocol was registered at clinicaltrials.gov (NCT04361721).
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Affiliation(s)
- Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy. .,Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.
| | - Roberto De Icco
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Gloria Vaghi
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Stefania Pazzi
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Elena Guaschino
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Marta Allena
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Natascia Ghiotto
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Daniele Martinelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Grazia Sances
- Headache Science and Neurorehabilitation Center, IRCCS Mondino Foundation, Pavia, Italy
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Torres-Ferrús M, Ursitti F, Alpuente-Ruiz A, Brunello F, Chiappino D, de Vries T, Di Marco S, Ferlisi S, Guerritore L, Gonzalez-Garcia N, Gonzalez-Martinez A, Khutorov D, Kritsilis M, Kyrou A, Makeeva T, Minguez-Olaondo A, Pilati L, Serrien A, Tsurkalenko O, Van den Abbeele D, van Hoogstraten WS, Lampl C. From transformation to chronification of migraine: pathophysiological and clinical aspects. J Headache Pain 2020; 21:42. [PMID: 32349653 PMCID: PMC7189559 DOI: 10.1186/s10194-020-01111-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/15/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic migraine is a neurological disorder characterized by 15 or more headache days per month of which at least 8 days show typical migraine features. The process that describes the development from episodic migraine into chronic migraine is commonly referred to as migraine transformation or chronification. Ample studies have attempted to identify factors associated with migraine transformation from different perspectives. Understanding CM as a pathological brain state with trigeminovascular participation where biological changes occur, we have completed a comprehensive review on the clinical, epidemiological, genetic, molecular, structural, functional, physiological and preclinical evidence available.
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Affiliation(s)
- M. Torres-Ferrús
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d’Hebron, Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute (VHIR), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F. Ursitti
- Headache Center, Child Neurology Unit, Bambino Gesu’ Children’s Hospital, Rome, Italy
| | - A. Alpuente-Ruiz
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d’Hebron, Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute (VHIR), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F. Brunello
- Juvenile Headache Centre, Department of Woman’s and Child’s Health, University Hospital of Padua, Padua, Italy
| | - D. Chiappino
- Department of Internal medicine, Sant’Andrea Hospital, University of Rome, Sapienza, Italy
| | - T. de Vries
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - S. Di Marco
- Department of Biomedicine Neuroscience and Advanced Diagnostics, Policlinico Paolo Giaccone Hospital, University of Palermo, Palermo, Italy
| | - S. Ferlisi
- Department of Biomedicine Neuroscience and Advanced Diagnostics, Policlinico Paolo Giaccone Hospital, University of Palermo, Palermo, Italy
| | - L. Guerritore
- Department of Internal medicine, Sant’Andrea Hospital, University of Rome, Sapienza, Italy
| | - N. Gonzalez-Garcia
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - A. Gonzalez-Martinez
- Neurology Department, Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - D. Khutorov
- Department of Clinical Neurology and Sleep Medicine, The Nikiforov Russian Center of Emergency and Radiation Medicine of EMERCOM of Russia, Saint-Petersburg, Russia
| | | | - A. Kyrou
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland University Hospital of Psychiatry, Bern, Switzerland
| | - T. Makeeva
- Headache Unit, Department of Neurology, Medical center “New Medical Technologies”, Voronezh, Russia
| | - A. Minguez-Olaondo
- Department of Neurology, Universitary Hospital of Donostia, San Sebastian, Spain
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
- Department of Neurology, Hospital Quironsalud Donostia, San Sebastian, Spain
| | - L. Pilati
- Department of Biomedicine Neuroscience and Advanced Diagnostics, Policlinico Paolo Giaccone Hospital, University of Palermo, Palermo, Italy
| | - A. Serrien
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - O. Tsurkalenko
- Department of Neurology and Neurosurgery, State Institution “Dnipropetrovsk medical akademy MOH Ukraine”, Dnipro, Ukraine
| | | | - W. S. van Hoogstraten
- Department of Neuroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - C. Lampl
- Headache Medical Center Linz, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - On behalf of School of Advanced Studies of European Headache Federation (EHF-SAS)
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d’Hebron, Headache and Neurological Pain Research Group, Vall d’Hebron Research Institute (VHIR), Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Headache Center, Child Neurology Unit, Bambino Gesu’ Children’s Hospital, Rome, Italy
- Juvenile Headache Centre, Department of Woman’s and Child’s Health, University Hospital of Padua, Padua, Italy
- Department of Internal medicine, Sant’Andrea Hospital, University of Rome, Sapienza, Italy
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Biomedicine Neuroscience and Advanced Diagnostics, Policlinico Paolo Giaccone Hospital, University of Palermo, Palermo, Italy
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
- Neurology Department, Hospital Universitario de La Princesa & Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Department of Clinical Neurology and Sleep Medicine, The Nikiforov Russian Center of Emergency and Radiation Medicine of EMERCOM of Russia, Saint-Petersburg, Russia
- Grevena General Hospital, Grevena, Greece
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland University Hospital of Psychiatry, Bern, Switzerland
- Headache Unit, Department of Neurology, Medical center “New Medical Technologies”, Voronezh, Russia
- Department of Neurology, Universitary Hospital of Donostia, San Sebastian, Spain
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
- Department of Neurology, Hospital Quironsalud Donostia, San Sebastian, Spain
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
- Department of Neurology and Neurosurgery, State Institution “Dnipropetrovsk medical akademy MOH Ukraine”, Dnipro, Ukraine
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
- Department of Neuroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Headache Medical Center Linz, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
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Abstract
With a controversial history, passive-aggressive personality disorder (PAPD) was eventually removed from the latest edition of the Diagnostic and Statistical Manual for Mental Disorders. Despite its demise from diagnostic nomenclature, clinicians continue to regard it as a clinically relevant construct, and some researchers argue for its resurrection. Toward this end, it is important to empirically demonstrate the relevance of the passive-aggressive personality construct, including demonstrating its association with impaired functioning. Consistent with contemporary emphasis on interpersonal functioning in personality pathology, the current study aims to explore interpersonal problems that are associated with PAPD in a large clinical sample. Before beginning treatment, 240 patients completed assessments of personality psychopathology and interpersonal functioning. Results showed that higher levels of PAPD were significantly associated with greater level of interpersonal distress, especially regarding interpersonal problems of a vindictive nature. The findings are consistent with clinical descriptions of the core conflictual relational issues of patients with PAPD and lend some support to further considering PAPD as a valid diagnostic construct.
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10
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11th International Congress on Psychopharmacology & 7th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1603000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Personality and Personality Disorders in Medication-Overuse Headache: A Controlled Study by SWAP-200. Pain Res Manag 2019; 2019:1874078. [PMID: 31281555 PMCID: PMC6594272 DOI: 10.1155/2019/1874078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/04/2019] [Indexed: 12/17/2022]
Abstract
Background Medication-overuse headache (MOH) is a type of chronic headache, whose mechanisms are still unknown. The impact of psychological factors has been matter of debate from different perspectives. The role of personality and personality pathology in processes involved in MOH development has been advanced but was poorly studied. The hypothesis of addiction-like behaviors sustaining the drug misuse has been examined and reached contrasting findings. Objectives This study is aimed at detecting personality and its disorders (PDs) in MOH, with a specific attention to the addiction aspect. Methods Eighty-eight MOH patients have been compared with two clinical populations including 99 patients with substance use disorder (SUD) and 91 with PDs using the Shedler-Westen Assessment Procedure-200 (SWAP-200), a clinician-report tool that assesses both normal and pathological personality. MANCOVAs were performed to evaluate personality differences among MOH, SUD, and PD groups, controlling for age and gender. Results MOH patients were predominantly women and older. They showed lower traits of the SWAP-200's cluster A and B disorders than SUD and PD patients, who presented more severe levels of personality impairment. No differences in the SWAP-200's cluster C have been found, indicating common personality features in these populations. At levels of specific PDs, MOH patients showed higher obsessive and dysphoric traits and better overall psychological functioning than SUD and PD patients. Conclusion Although MOH, SUD, and PD populations have been evaluated in multiple sites with different levels of expertise, the study supported the presence of a specific constellation of personality in MOH patients including obsessive (perfectionist) and dysphoric characteristics, as well as good enough psychological resources. No similarities to drug-addicted and personality-disordered patients were found. Practitioners' careful understanding of the personality characteristics of MOH patients may be useful to provide a road map for the implementation of more effective treatment strategies and intervention programs.
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Yang F, Dos Santos IAM, Gomez RS, Kummer A, Barbosa IG, Teixeira AL. Personality disorders are associated with more severe forms of migraine. Acta Neurol Belg 2019; 119:201-205. [PMID: 30474829 DOI: 10.1007/s13760-018-1050-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023]
Abstract
To investigate the clinical manifestation, disease course, and prognosis of migraine patients with or without personality disorders. This cross-sectional study evaluated 61 patients with migraine diagnosed according to the criteria of the International Headache Society (IHS). Personality disorders were assessed with the Structured Clinical Interview for DSM-IV (SCID-II). Migraine severity was assessed with the Headache Impact Test-6 (HIT-6). We also used a structured clinical interview to diagnose comorbid mood disorders. Of the 61 patients, 20 (32.8%) had personality disorders. Personality disorders included obsessive-compulsive 14/61 (23.0%), avoidant 6/61 (9.8%), borderline 6/61 (9.8%), paranoid 6/61 (9.8%), schizoid 2/61 (3.3%), histrionic 1/61 (1.6%) and dependent 1/61 (1.6%) types. Compared to migraine patients without personality disorders, comorbidity with any personality disorders was associated with an increased frequency of chronic migraine (p < 0.001) and more severe headache as assessed by the HIT-6 (p < 0.001). Comorbidity with personality disorders was associated with more severe forms of migraine symptoms.
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Affiliation(s)
- Fang Yang
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX, 77054, USA
| | - Igor Alvarenga Moreira Dos Santos
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Balena, 190, Belo Horizonte, MG, 30130-100, Brazil
| | - Rodrigo Santiago Gomez
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Balena, 190, Belo Horizonte, MG, 30130-100, Brazil
| | - Arthur Kummer
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Balena, 190, Belo Horizonte, MG, 30130-100, Brazil
| | - Izabela Guimarães Barbosa
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Balena, 190, Belo Horizonte, MG, 30130-100, Brazil
| | - Antonio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX, 77054, USA.
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Balena, 190, Belo Horizonte, MG, 30130-100, Brazil.
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Park SP, Seo JG. Aggression and its association with suicidality in migraine patients: a case-control study. J Headache Pain 2018; 19:67. [PMID: 30109431 PMCID: PMC6091355 DOI: 10.1186/s10194-018-0903-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/05/2018] [Indexed: 01/03/2023] Open
Abstract
Background To identify aggression and its association with suicidality in migraine patients. Methods We enrolled 144 migraine patients who made their first visit to our headache clinic. We collected data regarding their clinical characteristics and the patients completes the Aggression Questionnaire (AQ) and other questionnaires. We also interviewed patients with the Mini International Neuropsychiatric Interview—Plus Version 5.0.0 (MINI) to identify their suicidality. The degree of aggression in migraine patients was compared to the degree of aggression in healthy controls. Major determinants for aggression and its association with suicidality were also examined. Results The overall AQ score and anger and hostility subscale scores were higher in migraine patients than controls. For migraine chronicity, patients with chronic migraine (CM) had a higher overall AQ score and physical aggression, anger, and hostility subscale scores than controls. On the other hand, all AQ scores in patients with episodic migraine were not different from the scores of the controls. Although several factors were associated with the overall AQ score, major determinants were anxiety (ß = 0.395, p < 0.001), headache intensity (ß = 0.180, p = 0.016), and CM (ß = − 0.165, p = 0.037). Patients who had suicidality based on the MINI showed a higher overall AQ score than patients without suicidality (p < 0.001). Conclusions Aggression is likely to be a common feature in CM. Comorbid aggression may help to identify suicidality in migraine patients.
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Affiliation(s)
- Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
| | - Jong-Geun Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Kivilcim Y, Altintas M, Domac FM, Erzincan E, Gülec H. Screening for bipolar disorder among migraineurs: the impact of migraine-bipolar disorder comorbidity on disease characteristics. Neuropsychiatr Dis Treat 2017; 13:631-641. [PMID: 28280345 PMCID: PMC5338941 DOI: 10.2147/ndt.s121448] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the prevalence of comorbid bipolar disorder (BD) among migraineurs and the impact of migraine-BD comorbidity on disease characteristics. PATIENTS AND METHODS A total of 120 adult patients diagnosed with migraine at a single tertiary care center were included in this cross-sectional study. Data on sociodemographic and migraine-related characteristics, family history of psychiatric diseases, comorbid psychiatric diseases, and first-episode characteristics were recorded. Mood Disorders Diagnosis and Patient Registration Form (SCIP-TURK), Mood Disorder Questionnaire (MDQ), and Hypomania Checklist-32-Revised (HCL-32-R) were applied to all patients by experienced clinicians, and clinical diagnoses were confirmed using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Migraine Disability Assessment Scale (MIDAS) was used to evaluate the headache-related disability. Study parameters were compared between migraineurs with and without comorbid BD. RESULTS The diagnosis of comorbid BD was confirmed in 19.2% of migraineurs. A significantly higher percentage of patients with comorbid BD than those without comorbid BD had family history of BD (39.1% vs 6.2%, P<0.001), suicide attempt (30.4% vs 5.2%, P<0.001), and physical abuse (52.2% vs 26.8%, P=0.019). MIDAS scores were significantly higher (50.6 [43.2] vs 33.8 [42.7], P=0.0422) in migraineurs with comorbid BD than in those without comorbid BD. Multivariate logistic regression model revealed that a positive family history of type I BD (odds ratio [OR], 14.42; 95% confidence interval [CI], 2.94-70.73; P=0.001) and MIDAS scores >30 (OR, 3.69; 95% CI, 1.12-12.19; P=0.032) were associated with 14.42 times and 3.69 times increased likelihood of BD, respectively. CONCLUSION Our findings revealed comorbid BD in a remarkable percentage of migraineurs and a higher likelihood of having BD in case of a positive family history of type I BD and MIDAS scores >30. Comorbid BD was associated with a higher rate for a family history of BD, suicide attempt, and childhood physical abuse as well as aggravated migraine-related disability among migraineurs. Migraineurs with and without comorbid BD showed similar sociodemographic and migraine disease characteristics as well as similar high rates for comorbid anxiety and first-episode depression.
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Affiliation(s)
| | | | - Fusun Mayda Domac
- Department of Neurology, Erenköy Mental and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
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