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

Abstract

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. 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. 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). 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. 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.