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 usin g the revised version of the Minnesota Multiphasic Personality Inventory (M MPI-2) and to determine whether the data acquired were related to the anxie ty levels of the patients, as detected by the Spielberger State-Trait Anxie ty Inventory (STAI) 1, 2 and to the presence of a number of accompanying sy mptoms 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 th e Italian population Methods.-Five men and 30 women with chronic daily headache had a semistruct ured interview in which the presence of 21 behavioral or somatic symptoms w as recorded. The Italian version of the MMPI-2 and the STAI 1, 2 (Italian v ersion) were employed. A configural analysis of the MMPI profiles was perfo rmed, and four types were distinguished: "conversion V" (n = 5), elevation of the "neurotic triad" (n = 5), the "emotionally overwhelmed" with scale e levation 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 sy mptoms, and the STAI 1, 2 scores were assessed in all patients and in the d ifferent MMPI groups, and the data were statistically analyzed (ANOVA and c hi-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 signi ficantly lower than in all other groups. Moreover, in this group, the STAI 1, 2 scores and the prevalence of some accompanying symptoms were significa ntly lower than in the other groups. Migraine characteristics did not diffe r significantly from group to group. Conclusions.-Hysterical traits were observed in a number of patients with c hronic daily headache and might constitute a predisposing factor for this c ondition, With time, the personality profile deteriorates, either through a n increase in the hysterical traits or through its transformation, with a p arallel increase in anxiety levels and the presence of accompanying symptom s.