Psychopathological symptoms in patients suffering from chronic cephalea with or without fibromyalgia

Introduction. The presence of psychopathological symptoms as anxiety and depression in chronic daily headache and in fibromyalgia is common. Aim. To study whether there are any difference in the psychopathological profile and treatment response between patients with chronic headache and fibromyalgia (CHFM) and patients with chronic headache without fibromyalgia (CH). Patients and methods. A comprehensive psychological test battery was administered to 30 patients with CH and 30 patients with CHFM, diagnosed by a rheumatologist. We included chronic migraine and chronic tensional headache in CH group. Patients were matched for age and gender. Depression, anxiety and obsession scores, and the profile of psychopathological symptoms (MMPI-2, SCL-90-R) were compared (t-test). Correlations between symptoms and treatment response were examined. Results. Patients with CHFM showed significant highest scores on hypochondriasis, depression, hysteria, paranoia, psychasthenia and schizophrenia (MMPI-2) and more somatization, obsession and anxiety according to SCL-90-R. A poorer response to treatment was observed in CHFM (17.85%) versus CH (42,85%) group. Conclusions. Patients with CHFM showed a psychopathological profile with highest scores and symptoms than patients without fibromyalgia. These differences correlated with the therapeutic response. © 2009, Revista de Neurología.