For severe migraine sufferers, psychological treatments build on the benefits of drug therapy, according to a new study by Elizabeth Seng and Dr. Kenneth Holroyd from Ohio University in the US. Their comparison of the effects of various treatment combinations for severe migraine - drug therapy with or without behavioral management - shows that those patients receiving the behavioral management program alongside drug therapy are significantly more confident in their ability to use behavioral skills to effectively self-manage migraines.
And surprisingly, the increase in confidence in self-management abilities is greatest among those who feel that they have very little control over their condition before treatment starts. Seng's and Holroyd's findings are published online in Springer's journal Annals of Behavioral Medicine.
Seng and Holroyd analyzed data for 176 participants in the US Treatment of Severe Migraine Trial. Treatment programs included acute drug therapy for all, with either β-blockers or placebo - each with or without behavioral migraine management. The behavioral migraine management program consisted of demonstrations of migraine management skills during four monthly clinic visits, which were then applied between sessions by participants through workbooks, audiotape lessons, and guided home practice.
Their analyses showed that the addition of behavioral migraine management to drug therapy dramatically increased participants' confidence in their ability to effectively self-manage migraine, compared to migraine drug therapy alone. Behavioral management also increased participants' belief that migraines can be influenced by one's own behavior and decreased the belief that migraines are primarily influenced by chance or fate.
The authors conclude: "Our exploratory analyses offer an optimistic message: brief psychological interventions for migraine management can effectively increase sufferers' confidence in self-management and can be long-lasting." Psychological interventions enhanced drug therapy, enabling participants to take a more active role in their treatment by using behavioral skills to manage migraines.
Seng EK & Holroyd KA (2010). The dynamics of changes in self-efficacy and local of control expectancies in the behavioral and drug treatment of severe migraine. Annals of Behavioral Medicine; DOI:10.1007/s12160-010-9223-3