• medication overuse headache;
  • dependence;
  • validation;
  • questionnaire

Objectives.—To construct and validate a questionnaire measuring dependence on analgesics and on migraine attack treatments in headache patients.

Method.—The items were obtained using the Diagnostic and Statistic Manual of Mental Disorders (4th ed.) (DSM-IV) diagnostic criteria for dependence. The construct validity of the scale was investigated by confirmatory analysis in a sample of 156 patients. Regression analysis was used to explore predictive validity.

Results.—The 21 items of the scale were grouped into seven first-order factors corresponding to seven dependence items described in the DSM-IV. There was a second-order factor that may be considered as a general dependence factor. The global questionnaire score predicted the number of units of treatment taken per week, the number of days of headache, the number of days medications were taken, and emotional distress. Patients with headache associated with chronic substance use had a significantly higher score (P < .000) than migraine and tension headache patients.

Conclusion.—It is a practical and valid tool for measuring medication dependence, including the behavioral dimension of dependence, in patients with headache associated with chronic substance use. It can prevent patients and clinicians from only focusing on pharmacological dependence.