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 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. 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 the Italian population. METHODS: 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). 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 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. CONCLUSIONS: 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.