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Correspondence/Findings With great pleasure we write this Reply letter to the considerations, all of them indeed very interesting and thought-provoking, from Crombez relatively to a paper of validation of an existing instrument suitable/appropriate to our vision of a chronic migraine patient’s complexity [1]. The author uses a much ironic and opinionated style [2], obviously supported from his undisputed experience in the study of psychology of pain but with an undisputed limited experience in the study of chronic migraine and its complications (such as Medication Overuse Headache [MOH]) as well [3,4], a clinical area very variegated with multiple medical comorbidities, not only psychopathological ones [5]. His letter is specifically premeditated, providing a pulpit to widen the debate on the questioned attempt [4]. Firstly, the validity of the original test, the Stagnation Scale, has been widely confirmed and it is not our duty to re-discuss it, but maybe only to choose what to validate, its Italian version. Let’s proceed with order. The presence of emotional disturbances has been used to distinguish complicated cases of MOH (MOH Type II) [6-8] and although, it is necessary to screen MOH patients for anxiety and depression [9] psychological pain presentation might be multifaceted. Stagnation is a traditional Chinese medicine syndrome characterized by a cluster of mind/body obstruction-like symptoms such as feeling that something is stuck in the throat, chest and stomach, preoccupation or fear of losing what one possesses, and/or being unable to let go of some matters [10]. The construct of stagnation may capture some aspects of the psychological pain experienced from the individual that other Western

Questioning on consistency of a Stagnation Scale in Medication Overuse Headache: one more added to a plea of emperor’s clothes?