AUTHOR=Romozzi Marina , Di Tella Sonia , Rollo Eleonora , Quintieri Paolo , Silveri Maria Caterina , Vollono Catello , Calabresi Paolo 

TITLE=Theory of Mind in migraine and medication-overuse headache: A cross-sectional study

JOURNAL=Frontiers in Neurology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.968111

DOI=10.3389/fneur.2022.968111

ISSN=1664-2295

ABSTRACT=<sec><title>Background</title><p>Theory of Mind (ToM) is the ability to predict and anticipate others' behaviors through the mental state attribution process. This study aims to investigate the ToM in patients with medication-overuse headache (MOH) and episodic migraine (EM) and to compare it with healthy controls (HC).</p></sec><sec><title>Methods</title><p>This study enrolled patients with MOH, patients with EM, and HC. ToM was assessed through the Theory of Mind Assessment Scale (ThOMAS), which includes four subscales: Scale A, I-Me, Scale B, Other-Self, Scale C, I-Other, and Scale D, Other-Me, through the Reading the Mind in the Eyes test (RMET), which measures complex emotion recognition, and through the Toronto Alexithymia Scale (TAS-20), which measures alexithymia. Concomitant psychiatric disturbances were evaluated through the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, and the Dissociative Experiences Scale-II.</p></sec><sec><title>Results</title><p>The study involved 21 patients with EM, 22 patients with MOH, and 18 HC. In all the four subscales of the ThOMAS, there was a significant difference between HC, EM, and MOH patients: Scale A (<italic>p</italic> = 0.009), Scale B (<italic>p</italic> = 0.004), Scale C (<italic>p</italic> = 0.039), and Scale D (<italic>p</italic> = 0.008). In the RMET, MOH patients had worse performances than EM patients and HC (<italic>p</italic> = 0.039). MOH group exhibited higher levels of alexithymia when compared to the HC (<italic>p</italic> = 0.033) and higher levels of anxiety than HC (<italic>p</italic> = 0.001).</p></sec><sec><title>Conclusion</title><p>MOH patients showed a subtle psychopathological pattern characterized by impaired social adaptation.</p></sec>