Abstract text (incl. figure legends and references)

Background: The negative impact of medication overuse headache (MOH) on the quality of life (QoL) of the patient is undoubted.

Objective: The aim of this study was to identify clinical and headache related parameters that directly affect HRQoL of MOH patients.

Patients and Methods: 83 patients (11 men and 72 women) firstly diagnosed as having MOH and 81 healthy subjects (22 men and 59 women) in control group (CG) were enrloed in this study. The age of the study subjects range from 18 to 71 years. HRQoL was assessed using a Short Form - 36 questionnaire (SF-36), measuring its Physical Composite Score (PCS), Mental Composite Score (MCS) and Total score (TS).

Results: All HRQoL domeins (PCS, MCS, TS) were lower in MOH compared to the CG (p <0.001). In MOH, the depression itself is a risk factor for all aspects of HRQoL, for PCS (B = -0.70, 95% CI -1.32 - - 0.08, p = 0.027); for MCS (B = -0.71, 95% CI -1.14 - - 0.29, p = 0.001); for TS (B = -0.69, 95% CI -1.16 - - 0.22, p = 0.005)), with female gender being an associated risk factor only for PCS (B = -15.47, 95% CI -26.79 - - 4.14, p = 0.008). The results did not find a predictive role of anxiety, stress, and ruminative style of thinking for HRQoL in MOH patients (p>0.05).

Conclusions: Screening for depression among MOH patients and its treatment could be useful for improving their HRQoL.

Keywords: Medication overuse headache, Health related quality of life