EDITORIAL COMMENTARIES
The dependence scale: an easy tool to detect chronic daily headache with medication overuse?
1 Service de Neurologie et Pathologie Neurovasculaire, Hôpital Salengro, CHRU de Lille, Lille, France
2 Department of Neurology, University Hospital Essen, Essen, Germany
Correspondence to:
Dr Christian Lucas, Service de Neurologie et Pathologie Neurovasculaire, Hôpital Salengro, CHRU de Lille, 59037 Lille Cedex, France; clucas@chru-lille.fr
Accepted 6 March 2009
| The first 150 words of the full text of this article appear below. |
Chronic daily headache (CDH), defined by 
15 headache days/month for at least 3 months,1 is a major health problem which concerns approximately 3–4% of the general population.2 The total cost is also very high. It represents, for example, around 2 billion Euros in France per year.3 CDH is a descriptive entity in which the diagnosis could be essentially chronic tension-type headache and chronic migraine with or without medication overuse. The main complication of episodic tension-type headache and of episodic migraine is the chronification of headache, possibly associated with medication overuse. The 2004 revised International Classification of Headache Disorders (ICHD-II) has proposed definitions for these entities.1 Acute medications most often overused by subjects with probable chronic migraine (CM) comprise mainly paracetamol and fixed combination medications, more rarely non-steroidal anti-inflammatory drugs or triptans.
However, despite these data, CDH is probably underestimated and remains a difficult diagnosis for general practitioners.
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