Hypochondriasis, somatic amplification, and pain beliefs in patients with medication overuse headache

Medication overuse headache (MOH) is a chronic headache (CH) that develops or worsens due to medication overuse. Somatization and hypochondriasis, as well as beliefs about the experienced pain, may accompany many chronic pain situations from a holistic perspective.

This study aimed to compare MOH patients with CH and episodic headache (EH) in terms of somatization, hypochondriasis, and beliefs and attitudes on pain.

The Hospital Depression and Anxiety Scale (HADS), the Somatosensory Amplification Scale (SSAS), the Pain Beliefs Questionnaire (PBQ), the Pain Catastrophizing Scale (PCS), Eysenck Personality Questionnaire Revised-Short Form (EPQR-S), and Whiteley index-7 (WI-7) were administered to the participants with MOH (n = 80), CH (n = 81), and EH (n = 79).

There were no group differences in terms of somatic amplification between MOH and CH group. A high WI_Total score (lower hypochondriacal tendency) was predictive in separating the MOH group from the CH one. The score obtained from the PBQ_Organic subscale in the MOH group was significantly lower than the EH group, while the PCS_Total, PCS_Helplessness, PCS_Rumination, and HADS scores were significantly higher (p < 0.05).

Our results indicate that the patients in the MOH group had more organic pain beliefs, felt more helpless in case of pain, and experienced exaggeration and rumination more than the EH group, while hypochondriasis was lower than in the CH group. This could indicate that patients with MOH do not seek further treatment that can lead to more headache medication use without medical examination.