{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:13:01Z","timestamp":1783649581599,"version":"3.55.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,6,27]],"date-time":"2018-06-27T00:00:00Z","timestamp":1530057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"COMOESTAS Project \u2013 FP7 \u2013 Thematic priority ICT","award":["EC contract number 215366 (COMOESTAS)"],"award-info":[{"award-number":["EC contract number 215366 (COMOESTAS)"]}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify factors that may be predictors of the outcome of a detoxification treatment in medication-overuse headache.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients entering a detoxification program in six centres in Europe and Latin America were evaluated and followed up for 6 months. We evaluated anxious and depressive symptomatology (though patients with severe psychiatric comorbidity were excluded), quality of life, headache-related disability, headache characteristics, and prophylaxis upon discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 492 patients who completed the six-month follow up, 407 ceased overuse following the detoxification (non overusers), another 23 ceased overuse following detoxification but relapsed during the follow-up. In the 407 non-overusers, headache acquired an episodic pattern in 287 subjects (responders). At the multivariate analyses, lower depression scores (odds ratio\u2009=\u20090.891; p\u2009=\u20090.001) predicted ceasing overuse. The primary headache diagnosis \u2013 migraine with respect to tension-type headache (odds ratio\u2009=\u20090.224; p\u2009=\u20090.001) or migraine plus tension-type headache (odds ratio\u2009=\u20090.467; p\u2009=\u20090.002) \u2013 and the preventive treatment with flunarizine (compared to no such treatment) (odds ratio\u2009=\u20090.891; p\u2009=\u20090.001) predicted being a responder. A longer duration of chronic headache (odds ratio\u2009=\u20091.053; p\u2009=\u20090.032) predicted relapse into overuse. Quality of life and disability were not associated with any of the outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Though exploratory in nature, these findings point to specific factors that are associated with a positive outcome of medication-overuse headache management, while identifying others that may be associated with a negative outcome. Evaluation of the presence\/absence of these factors may help to optimize the management of this challenging groups of chronic headache sufferers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0333102418783317","type":"journal-article","created":{"date-parts":[[2018,6,27]],"date-time":"2018-06-27T03:02:33Z","timestamp":1530068553000},"page":"135-147","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Psychological, clinical, and therapeutic predictors of the outcome of detoxification in a large clinical population of medication-overuse headache: A six-month follow-up of the COMOESTAS Project"],"prefix":"10.1177","volume":"39","author":[{"given":"Sara","family":"Bottiroli","sequence":"first","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Allena","sequence":"additional","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Sances","sequence":"additional","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9415-4948","authenticated-orcid":false,"given":"Roberto","family":"De Icco","sequence":"additional","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"},{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micol","family":"Avenali","sequence":"additional","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"},{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Fadic","sequence":"additional","affiliation":[{"name":"Department of Neurology, Pontificia Catolica University of Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaza","family":"Katsarava","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel JA","family":"Lainez","sequence":"additional","affiliation":[{"name":"Foundation of the Valencian Community, University Clinical Hospital, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Goicochea","sequence":"additional","affiliation":[{"name":"Integral Pain Centre, Fundaci\u00f3n para la Lucha contra las Enfermedades Neurol\u00f3gicas Infantiles (FLENI), Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Bendtsen","sequence":"additional","affiliation":[{"name":"Danish Headache Centre, Department of Neurology, Glostrup Hospital, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rigmor H\u00f8jland","family":"Jensen","sequence":"additional","affiliation":[{"name":"Danish Headache Centre, Department of Neurology, Glostrup Hospital, Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Nappi","sequence":"additional","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1513-2113","authenticated-orcid":false,"given":"Cristina","family":"Tassorelli","sequence":"additional","affiliation":[{"name":"Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy"},{"name":"Department of Brain and Behavioral Sciences, University of Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the COMOESTAS Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,6,27]]},"reference":[{"key":"bibr1-0333102418783317","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03497.x"},{"key":"bibr2-0333102418783317","doi-asserted-by":"publisher","DOI":"10.1177\/0333102412451363"},{"key":"bibr3-0333102418783317","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2009.01934.x"},{"key":"bibr4-0333102418783317","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(91)90102-U"},{"key":"bibr5-0333102418783317","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2005.00910.x"},{"key":"bibr6-0333102418783317","first-page":"2","volume":"5","author":"Lipton RB","year":"1998","journal-title":"Clin 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