Migraine Clinical Trial
Official title:
Evaluation of the Efficacy of Trans-diagnostic Cognitive-behavioral Therapy on Controlling and Reducing Headache and Associated Symptoms Among Migrainous Patients
Migraine headache is one of the disabling conditions that may be associated with decreased
quality of life, anxiety and depression. Currently, therapeutic approach to migraine is
mostly based on prophylactic and acute phase medication therapy. Some investigators consider
migraine a biopsychosocial condition which means that psychological therapies, such as
cognitive-behavioral therapy and relaxation, may be efficient in controlling the disease.
According to previous studies, cognitive therapies, including cognitive-behavioral therapy,
have been efficient in decreasing frequency and severity of migraine, however, there are some
challenges in applying these kind of interventions: the expenses; presence of multiple
commodities that may lead to confusion and bewilderment for both therapist and patient; small
number of trained psychologists for this intervention.
The trans-diagnostic approach, however, can facilitate some challenges with the previous
method. Since it is not focused on a single condition, trained psychologists with this
approach can apply it for a wide range of conditions, including migraine. Also, the
trans-diagnostic approach leads to lower chances of confusion and bewilderment for therapist
and patients. The trans-diagnostic approach focuses on therapeutic modules instead of
constant similar therapeutic models. The five cores of trans-diagnostic approach are
emotional awareness, cognitive flexibility, recognizing and preventing emotion avoidance and
maladaptive emotion driven behaviors, awareness and tolerance of emotion-related physical
conditions, and introceptive and situation-based emotion-focused exposure. This method was
first designed to replace cognitive-behavioral therapy for emotional disorders, due to its
feasibility and applicability.
The trans-diagnostic approach has been investigated by several researchers so far, however,
most of those researches evaluate the efficacy of the technique on psychiatric disorders. It
has also been investigated for treatment of headaches in adolescents. But no other study on
other clinical problems or migraine has been conducted. Considering the high rates of
comorbid anxiety and depressive symptoms in migrainous patients and the feasibility and
efficacy of trans-diagnostic cognitive-behavioral therapy in other conditions, we aimed to
evaluate its efficacy on controlling headache and related symptoms among migrainous patients.
Migraine headache is one of the disabling conditions that occurs more in young women. It is
usually associated with decreased quality of life, as well as anxiety and depressed in the
affected individuals. Currently, therapeutic approach to migraine is mostly based on
medication therapy in two phases of prophylaxis and acute attacks. However, some
investigators consider it not only as a biologic disease, but also a multidimensional
condition that may be accompanied by anxiety and depressive symptoms. Considering migraine as
a biopsychosocial condition means that psychological therapies, such as cognitive-behavioral
therapy and relaxation, may be efficient in controlling the disease. According to previous
studies, cognitive therapies, including cognitive-behavioral therapy, have been efficient in
decreasing frequency and severity of migraine, however, there are some challenges in applying
these kind of interventions for patients: the costs of such treatments are usually not
covered by insurance companies; presence of multiple commodities may lead to confusion and
bewilderment for both therapist and patient while applying the technique; training
psychologists for this intervention is costly and not enough psychologists know how to handle
the condition.
The trans-diagnostic approach, however, can facilitate some challenges with the previous
method. Since it is not focused on a single condition, trained psychologists with this
approach can apply it for a wide range of conditions, including migraine. Also, the
trans-diagnostic approach leads to lower chances of confusion and bewilderment for therapist
and patients.
The trans-diagnostic approach is somehow similar to the classic cognitive-behavioral therapy.
however, it focuses on therapeutic modules instead of constant similar therapeutic models.
The five cores of trans-diagnostic approach are emotional awareness, cognitive flexibility,
recognizing and preventing emotion avoidance and maladaptive emotion driven behaviors,
awareness and tolerance of emotion-related physical conditions, and introceptive and
situation-based emotion-focused exposure. This method was first designed to replace
cognitive-behavioral therapy for emotional disorders, due to its feasibility and
applicability.
The trans-diagnostic approach has been investigated by several researchers so far, however,
most of those researches evaluate the efficacy of the technique on psychiatric disorders. It
has also been investigated for treatment of headaches in adolescents. But no other study on
other clinical problems or migraine has been conducted. Considering the high rates of
comorbid anxiety and depressive symptoms in migrainous patients and the feasibility and
efficacy of trans-diagnostic cognitive-behavioral therapy in other conditions, we aimed to
evaluate its efficacy on controlling headache and related symptoms among migrainous patients.
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