Effectiveness of Behavior Management Intervention in Migraine With a Focus on Comorbid Depressive Symptoms

Migraine negatively affects sufferers’ physical and mental health and social and economic status.

This study compared the effectiveness of behavior management therapy and pharmacotherapy in reducing migraine-related disabilities with and without focusing on comorbid depressive symptoms.

This quasi-experimental study has a pre-test-post-test design with a control group. The study was conducted on migrainous patients with comorbid depressive symptoms referred to neurology clinics in Rasht City, Iran, in 2021. A total of 18 female patients were selected using purposive sampling based on neurological diagnosis and the diagnostic and statistical manual of mental disorders (DSM-5) criteria for depressive disorder. The participants were randomly assigned to two groups after matching regarding age and severity of depression. Combined therapy (behavior management intervention [BM] and pharmacotherapy [P]) was performed in two groups during eight sessions, with (case group) and without (control group) focusing on comorbid depressive symptoms. The data were collected using the Beck depression inventory (BDI-II), the headache disability inventory (HDI), and the headache diary (HD) and analyzed using multivariate analysis of covariance.

The first therapeutic approach was significantly superior to the second in reducing migraine-related disabilities (F(2, 13)=10.43, P<0.05, Wilks Lambda=0.384, partial Ƞ2 =0.616).

Combined therapy (BM & P) focusing on comorbid depressive symptoms can be an alternative or complementary therapeutic method to reduce various disabilities in migraine patients.