Top

BMC Neurology

Published in:

Open Access 01-12-2022 | Migraine | Research

The efficacy of transdiagnostic cognitive behavioral therapy on migraine headache: a pilot, feasibility study

Authors: Forouzandeh Soleimanian-Boroujeni, Negin Badihian, Shervin Badihian, Vahid Shaygannejad, Yousef Gorji

Published in: BMC Neurology | Issue 1/2022

Abstract

Introduction

Psychological interventions are shown to be effective in migraine, but not utilized routinely yet. We aimed to evaluate the efficacy of transdiagnostic cognitive behavioral therapy (TCBT) on people with migraine (PwM).

Method

This study was conducted on 40 PwM aged 20–50 years. We randomly assigned participants to two groups of intervention, receiving 10 sessions of TCBT, and control, attending one session on relaxation and stress-management techniques. Days with headache, headache severity, migraine-related disability and effects on daily life, number of pain-relivers taken for headache, depression, and anxiety were assessed pre-intervention, post-intervention (three-month follow-up), and one-month after TCBT termination (four-month follow-up).

Results

Thirty-five participants suffering moderate to severe migraine completed the study (16 and 19 in TCBT and control groups, respectively). TCBT improved all measured items between study time-points (p < 0.05) in the intervention group, while such an improvement was not observed in the control group. Between group comparisons revealed superiority of TCBT group compared to the control group in most measured items at three- and four-month follow-ups (p < 0.05).

Conclusion

Ten sessions of TCBT improved migraine severity, associated disability, anxiety, and depression in PwM, with persistent effects after one month of therapy termination. However, the generalizability of these findings is limited due to the placebo effect in the intervention arm, given the more time each participant has spent with the therapist. TCBT could be an affordable, practical, and feasible intervention to be utilized for PwM and larger studies with equal number of sham therapy sessions are needed to further explore this.

Trial registration number: The study protocol was registered in clinicaltrial.gov (NCT03701477) prior to enrollment.

Stovner LJ, Nichols E, Steiner TJ, Abd-Allah F, Abdelalim A, Al-Raddadi RM, et al. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 2018;17(11):954–76. https://doi.org/10.1016/s1474-4422(18)30322-3.CrossRef

Woldeamanuel YW, Cowan RP. Migraine affects 1 in 10 people worldwide featuring recent rise: A systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci. 2017;372:307–15. https://doi.org/10.1016/j.jns.2016.11.071.CrossRefPubMed

Messali A, Sanderson JC, Blumenfeld AM, Goadsby PJ, Buse DC, Varon SF, et al. Direct and Indirect Costs of Chronic and Episodic Migraine in the United States: A Web-Based Survey. Headache. 2016;56(2):306–22. https://doi.org/10.1111/head.12755.CrossRefPubMed

Buse DC, Silberstein SD, Manack AN, Papapetropoulos S, Lipton RB. Psychiatric comorbidities of episodic and chronic migraine. J Neurol. 2013;260(8):1960–9. https://doi.org/10.1007/s00415-012-6725-x.CrossRefPubMed

Bigal ME, Lipton RB. The epidemiology, burden, and comorbidities of migraine. Neurol Clin. 2009;27(2):321–34. https://doi.org/10.1016/j.ncl.2008.11.011.CrossRefPubMed

Ha H, Gonzalez A. Migraine Headache Prophylaxis. Am Fam Physician. 2019;99(1):17–24.PubMed

Hepp Z, Dodick DW, Varon SF, Gillard P, Hansen RN, Devine EB. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia. 2015;35(6):478–88.CrossRef

Hepp Z, Bloudek LM, Varon SF. Systematic review of migraine prophylaxis adherence and persistence. J Manag Care Pharm. 2014;20(1):22–33. https://doi.org/10.18553/jmcp.2014.20.1.22.CrossRefPubMed

Singer AB, Buse DC, Seng EK. Behavioral treatments for migraine management: useful at each step of migraine care. Current neurology and neuroscience reports. 2015;15 4:14; doi: https://doi.org/10.1007/s11910-015-0533-5.

10.

Sullivan A, Cousins S, Ridsdale L. Psychological interventions for migraine: a systematic review. J Neurol. 2016;263(12):2369–77. https://doi.org/10.1007/s00415-016-8126-z.CrossRefPubMedPubMedCentral

11.

Harris P, Loveman E, Clegg A, Easton S, Berry N. Systematic review of cognitive behavioural therapy for the management of headaches and migraines in adults. Br J Pain. 2015;9(4):213–24. https://doi.org/10.1177/2049463715578291.CrossRefPubMedPubMedCentral

12.

Minen MT, Jalloh A, Begasse de Dhaem O, Seng EK. Behavioral Therapy Preferences in People With Migraine. Headache. 2020;60 6:1093–102; doi: https://doi.org/10.1111/head.13790.

13.

Bullis JR, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Carl JR, Barlow DH. The unified protocol for transdiagnostic treatment of emotional disorders: preliminary exploration of effectiveness for group delivery. Behav Modif. 2015;39(2):295–321. https://doi.org/10.1177/0145445514553094.CrossRefPubMed

14.

Harvey A, Watkins E, Mansell W, Shafran R. Cognitive Behavioural Processes across Psychological Disorders: a Transdiagnostic approach to research and treatment. New York: Oxford University Press; 2004.

15.

Sharma P, Mehta M, Sagar R. Efficacy of transdiagnostic cognitive-behavioral group therapy for anxiety disorders and headache in adolescents. J Anxiety Disord. 2017;46:78–84. https://doi.org/10.1016/j.janxdis.2016.11.001.CrossRefPubMed

16.

Society HCCotIH. The international classification of headache disorders, (beta version). Cephalalgia. 2013;33 9:629–808.

17.

Sharma P, Mehta M, Sagar R. Headache—A Transdiagnostic Approach. In: A Practical Approach to Cognitive Behaviour Therapy for Adolescents. Springer; 2015. p. 285–310.

18.

Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16 1:87–101; doi: https://doi.org/10.1016/0304-3959(83)90088-X.

19.

Zandifar A, Banihashemi M, Haghdoost F, Masjedi SS, Manouchehri N, Asgari F, et al. Reliability and Validity of the Persian HIT-6 Questionnaire in Migraine and Tension-type Headache. Pain practice : the official journal of World Institute of Pain. 2014;14(7):625–31. https://doi.org/10.1111/papr.12120.CrossRef

20.

Yang M, Rendas-Baum R, Varon SF, Kosinski M. Validation of the Headache Impact Test (HIT-6) across episodic and chronic migraine. Cephalalgia. 2011;31(3):357–67. https://doi.org/10.1177/0333102410379890.CrossRefPubMedPubMedCentral

21.

Zandifar A, Asgari F, Haghdoost F, Masjedi SS, Manouchehri N, Banihashemi M, et al. Reliability and validity of the migraine disability assessment scale among migraine and tension type headache in Iranian patients. Biomed Res Int. 2014;2014: 978064. https://doi.org/10.1155/2014/978064.CrossRefPubMedPubMedCentral

22.

Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology. 2001;56(6 Suppl 1):S20–8. https://doi.org/10.1212/wnl.56.suppl_1.s20.CrossRefPubMed

23.

Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health Qual Life Outcomes. 2003;1:14. https://doi.org/10.1186/1477-7525-1-14.CrossRefPubMedPubMedCentral

24.

Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of psychosomatic research. 2002;52 2:69–77; doi: https://doi.org/10.1016/s0022-3999(01)00296-3.

25.

Stirman SW, Gutner CA, Langdon K, Graham JR. Bridging the gap between research and practice in mental health service settings: An overview of developments in implementation theory and research. Behav Ther. 2016;47(6):920–36.CrossRef

26.

Herschell AD, McNeil CB, McNeil DW. Clinical child psychology’s progress in disseminating empirically supported treatments. Clinical Psychology: Science. 2004;11(3):267–88.

27.

McEvoy PM, Nathan P, Norton PJ. Efficacy of Transdiagnostic Treatments: A Review of Published Outcome Studies and Future Research Directions. J Cogn Psychother. 2009;23(1):20–33. https://doi.org/10.1891/0889-8391.23.1.20.CrossRef

28.

Crawley SA, Kendall PC, Benjamin CL, Brodman DM, Wei C, Beidas RS, et al. Brief Cognitive-Behavioral Therapy for Anxious Youth: Feasibility and Initial Outcomes. Cogn Behav Pract. 2013;20(2):123–33. https://doi.org/10.1016/j.cbpra.2012.07.003.CrossRef

29.

Klan T, Liesering-Latta E, Gaul C, Martin PR, Witthoft M. An Integrative Cognitive Behavioral Therapy Program for Adults With Migraine: A Feasibility Study. Headache. 2019;59(5):741–55. https://doi.org/10.1111/head.13532.CrossRefPubMed

30.

Sajadinejad MS, Mohammadi N, Taghavi SMR, Ashgazadeh N. Therapeutic Effects of Cognitive-Behavioral Group Therapy on Headache Disability and Depression in Patients with Migraine and Tension Headache. Iranian Journal of Psychiatry and Clinical Psychology. 2009;14(4):411–8.

31.

Bigal ME. Lipton RBJHTJoH, Pain F. Modifiable risk factors for migraine progression. 2006;46(9):1334–43.

32.

Peroutka SJJCp, reports h. What turns on a migraine? A systematic review of migraine precipitating factors. 2014;18 10:454.

Title: The efficacy of transdiagnostic cognitive behavioral therapy on migraine headache: a pilot, feasibility study
Authors: Forouzandeh Soleimanian-Boroujeni
Negin Badihian
Shervin Badihian
Vahid Shaygannejad
Yousef Gorji
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Migraine
Mood Disorders
Affective Disorder
Headache
Anxiety
Published in: BMC Neurology / Issue 1/2022
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-022-02729-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The efficacy of transdiagnostic cognitive behavioral therapy on migraine headache: a pilot, feasibility study

Abstract

Introduction

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2022

Simple and effective serum biomarkers potential for predicting status epilepticus in anti-N-methyl-D-aspartate receptor encephalitis

Leukoencephalopathy with brain calcifications and cysts (Labrune syndrome) case report: diagnosis and management of a rare neurological disease

The barriers and facilitators to health-promoting lifestyle behaviors among people with multiple sclerosis during the coronavirus disease 2019 pandemic: a content analysis study

Personalized neurorehabilitative precision medicine: from data to therapies (MWKNeuroReha) – a multi-centre prospective observational clinical trial to predict long-term outcome of patients with acute motor stroke

Normal parameters for diagnostic transcranial magnetic stimulation using a parabolic coil with biphasic pulse stimulation

Preliminary study on brain resting-state networks and cognitive impairments of patients with obstructive sleep apnea–hypopnea syndrome