Cognitive behavioral therapy for chronic migraine

2017 ◽  
Vol 41 (S1) ◽  
pp. s500-s500 ◽  
Author(s):  
O. Onur ◽  
D.H. Ertem ◽  
D. Uludüz ◽  
Ç. Karşıdağ
Keyword(s):  
Chronic Migraine ◽  
Psychological Treatment ◽  
Treatment Options ◽  
Depression Scale ◽  
Migraine Treatment ◽  
Hamilton Depression Scale ◽  
Post Traumatic Stress ◽  
Current Standard ◽  
Significant Difference ◽  
Hamilton Anxiety

AimAlthough current standard treatment for migraine headache is medication, high levels of psychological comorbidity has led to migraine influencing by cognitive, emotional and environmental factors, as well as biological. Viewing migraine in a biopsychosocial framework introduces the possible utilisation of psychological treatment options, such as cognitive behavioural therapy (CBT). The aim of this study was to evaluate the efficacy of CBT for chronic migraine.MethodologyThirty-five participants diagnosed as chronic migraine were recruited from Headache Clinic. According to inclusion criteria 14 participants, underwent bi-weekly lasting 30 minutes CBT sessions for 6 months, were administered Hamilton Anxiety Scale, Hamilton Depression Scale, Visual Analog Scale (VAS) and the Migraine Disability Assessment Scale (MİDAS) before and after CBT.FindingsNine of the participants were female and 5 male. Mean age of group was 34.35 ± 8.17. Duration of illness was 13.07 ± 7.18 and 12 of participants had the history of a psychiatry illness whose diagnoses were depression (7), anxiety disorder (4) and post-traumatic stress disorder (1). Nine of the patients had prophylactic migraine treatment. There were statistically significant difference in Hamilton Depression scores between before CBT (29.07 ± 7.74) and after CBT (14.21 ± 7.7); in Hamilton Anxiety scores before CBT (26.8 ± 11.7) and after CBT (11.7 ± 2.6); in VAS scores before CBT (8.07± 0.91) and after CBT (3.71 ± 1.32); in frequency of migraine attacks between before CBT (10.85 ± 3.50 day) and after CBT (4.92 ± 2.70 day) and in MİDAS before CBT (55.5 ± 20.4) and after CBT (20.12 ± 16.6) (P < 0.05).ConclusionCBT might reduce the severity of symptoms in migraine patients especially with the comorbidity of psychiatric illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals An assessment of the mental health of mastectomized women in South India

2016 ◽  
Vol 5 (3) ◽  
pp. 214-228
Author(s):  
Sukanya B. Menon ◽  
C. Jayan
Keyword(s):  
Psychiatric Diagnosis ◽  
Psychological Treatment ◽  
Psychiatric Morbidity ◽  
Psychological Impact ◽  
Depression Scale ◽  
Well Being ◽  
Breast Cancer Patients ◽  
Event Scale ◽  
Significant Difference ◽  
The Impact

AimThe present study is aimed at understanding the psychiatric morbidity among mastectomized women and in identifying differences in depression, anxiety, psychological impact and well-being based on psychiatric diagnosis.MethodOne hundred and sixty breast cancer patients who had undergone mastectomy and were on either on adjuvant therapies or on waiting list were interviewed. The Mini-International Neuropsychiatric Interview (M.I.N.I.) - Plus, Hospital Anxiety and Depression Scale, the Impact of Event Scale and the Psychological General Well-Being Schedule were used.ResultsAround 68% of patients did not meet psychiatric diagnosis, while the remaining 32% patients were found to have psychiatric morbidity. Of these, 15% diagnosed with adjustment disorders, 13% patients with a major depressive disorder, while 4% patients with anxiety disorders. A significant difference in anxiety, depression, psychological impact and well-being was found among mastectomized women who were grouped on the basis of their psychiatric diagnosis.ConclusionPsychiatric morbidity is evident in patients. This study reinforces the need for identifying psychiatric disorders among women who are undergoing mastectomy, in order to provide adequate psychological treatment.

scholarly journals Correlation of Catecholamine Content and Clinical Influencing Factors in Depression among Psoriasis Patients: A Case-Control Study

2020 ◽  
Author(s):  
Hui-Ling Shu ◽  
Jing Fang ◽  
Deng-Mei Xia ◽  
Zheng-Qun Wang ◽  
Wen-Yao Mi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Influencing Factors ◽  
Psoriasis Vulgaris ◽  
Depression Scale ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Dermatology Department ◽  
Dopamine Content ◽  
Significant Difference ◽  
The Mean

Abstract Backgroud: This study sought to investigate the clinical influencing factors of patients with psoriasis vulgaris complicated with depression, and to analyze whether the content of monoamine neurotransmitters in plasma was correlated with depression incidence among psoriasis patients. Methods Ninety patients aged 18-60 years with psoriasis vulgaris referred to the dermatology department and 40 healthy volunteers aged 18-60 years referred to the physical examination center of the Affiliated Hospital of Southwest Medical University were included. Questionnaires were administered in both groups to obtain basic patient information, Hamilton Depression Scale(HAMD), and Athens Insomnia Scale(AIS) scores. The questionnaire only for patients with psoriasis vulgaris included the course of disease, Psoriasis Area and Severity Index (PASI), and Dermatology Life Quality Index (DLQI). The catecholamine in plasma from the two groups was analyzed by radioimmunoassay. The data were analyzed by SPSS statistical software. Results: The mean HAMD (P=0.034) and mean AIS scores (P=0.001) of the psoriasis patients were higher than those of the control group, while the mean content of dopamine (P=0.004) and adrenaline in the plasma (P=0.007) of the psoriasis group were lower than those of the control group. Dopamine content in the plasma was lower (comparing psoriasis patients without depression and the control group: P<0.001), and was negatively correlated with HAMD, (P<0.05), AIS (P<0.05), and PASI scores (P<0.05) in the psoriasis patients with depression. There was no significant difference in the epinephrine and norepinephrine contents in all groups. PASI scores were positively correlated with HAMD scores in patients with psoriasis vulgaris, and the mean dopamine content in the patients with depression (P=0.001) was significantly lower than in those without depression. The low dopamine content and high PASI and DLQI scores were the risk factors for depression among the patient population. Conclusion: Psoriasis patients have a significantly higher risk of depression than healthy people, and higher PASI scores were linked to a higher incidence of depression. The dopamine levels of patients were influenced by both psoriasis and depression. The risk factors for depression in psoriasis patients are low dopamine levels in the plasma, severe skin lesions, and lower quality of life.

scholarly journals Chronic Migraine

Migraine ◽  
2020 ◽  
Author(s):  
Diana Obelieniene ◽  
Ruta Pestininkaite ◽  
Daiva Rastenyte
Keyword(s):  
Valproic Acid ◽  
Chronic Migraine ◽  
Migraine Headache ◽  
Treatment Options ◽  
Migraine Treatment ◽  
Evidence Based ◽  
New Developments ◽  
Onabotulinumtoxin A ◽  
History Of ◽  
Over Time

Chronic migraine as a disease was initially recognized in patients with a large burden of disability from frequent headaches and a history of prior migraines. Over time, this observation was operationalized into multiple diagnostic criteria with requirements for frequent headache days, typically 15 or more, which, on at least 8 days in a month, have the features of migraine headache. Chronic migraine affects 1–2% of the general population, and about 8% of patients with migraine. Understanding disease mechanisms still remains a challenge. Inflammation and central sensitization play significant role in the evolutive mechanisms of chronic migraine. Treatment of this condition should primarily focus on the prevention. The currently available evidence-based prophylactic treatment options are topiramate, valproic acid, onabotulinumtoxin A and recently developed promising anti-CGRP monoclonal antibodies. Chronic migraine research is a dynamic and rapidly advancing area. New developments in this field have the potential to improve the diagnosis, to provide more personalized treatments and to reduce burden of disability.

Problemi di psicoterapia

2009 ◽  
pp. 45-56
Author(s):  
Paolo Migone
Keyword(s):  
Clinical Trials ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Randomized Clinical Trials ◽  
Interpersonal Relationship ◽  
Depression Scale ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Hamilton Depression Scale ◽  
Significant Difference

- Kirsch et al. (2002) studied all 47 randomized clinical trials (RCT) submitted by pharmaceutical companies to the U.S. Food and Drug Administration (FDA) for approval of the six most prescribed Selective Serotonin Reuptake Inhibitors (SSRI) antidepressants. The mean difference between drug and placebo was less than 2 points on the 21-item (62- point) Hamilton Depression Scale (which is the version used in many of the these RTCs). This superiority to placebo, although statistically significant, was not clinically significant. Furthermore, 57% of the trials funded by the pharmaceutical industry failed to show a significant difference between drug and placebo. Most of these negative data were not published and were accessible only thanks to the Freedom of Information Act. Also other studies confirming this research (Whittington et al., 2004; Moncrieff & Hardy, 2007; Turner et al., 2008) are presented. These data are discussed in light of the wider problem of the roles of interpersonal relationship in psychiatric practice.KEY WORDS: antidepressants drugs, Selective Serotonin Reuptake Inhibitors (SSRI), placebo, Kirsch, Randomized Clinical Trials (RCT)]

scholarly journals Transcranial pulsed electromagnetic fields for treatment-resistant depression: A multicenter 8-week single-arm cohort study

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Erik Roj Larsen ◽  
Rasmus W. Licht ◽  
René Ernst Nielsen ◽  
Annette Lolk ◽  
Bille Borck ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antidepressant Treatment ◽  
Treatment Options ◽  
Depression Scale ◽  
Antidepressant Effect ◽  
Hamilton Depression Scale ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Resistant Depression ◽  
Pulsed Electromagnetic

Abstract Background. The efficacy of antidepressant treatment is fair, but the efficacy is considerably lower in patients failing two or more trials underscoring the need for new treatment options. Our study evaluated the augmenting antidepressant effect of 8-weeks transcranial pulsed electromagnetic field (T-PEMF) therapy in patients with treatment-resistant depression. Methods. A multicenter 8-week single-arm cohort study conducted by the Danish University Antidepressant Group. Results. In total, 58 participants (20 men and 38 women) with a moderate to severe depression as part of a depressive disorder according to ICD-10 who fulfilled criteria for treatment resistance were included, with 19 participants being nonresponders to electroconvulsive therapy during the current depressive episode. Fifty-two participants completed the study period. Scores on the Hamilton Depression Scale 17-items version (HAM-D17) decreased significantly from baseline (mean = 20.6, SD 4.0) to endpoint (mean = 12.6, SD 7.1; N = 58). At endpoint, utilizing a Last Observation Carried Forward analysis, 49 and 28% of those participants with, respectively, a nonchronic current episode (≤2 years; N = 33) and a chronic current episode (>2 years; N = 25) were responders, that is, achieved a reduction of 50% or more on the HAM-D17 scale. At endpoint, respectively, 30 and 16% obtained remission, defined as HAM-D17 ≤ 7. On the Hamilton Scale 6-item version (HAM-D6), respectively, 51 and 16% obtained remission, defined as HAM-D6 ≤ 4. Conclusions. The findings indicate a potential beneficial role of T-PEMF therapy as an augmentation treatment to ongoing pharmacotherapy in treatment-resistant depression.

scholarly journals Clinician-Patient Dialogue About Preventive Chronic Migraine Treatment

2020 ◽  
Vol 11 ◽  
pp. 215013272095993
Author(s):  
Andrew M. Blumenfeld
Keyword(s):  
Chronic Migraine ◽  
Treatment Approach ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Severe Form ◽  
Migraine Treatment ◽  
Appropriate Treatment ◽  
The Individual ◽  
Practical Recommendations

Many new medications for the treatment of migraine are now available on the market. In the current evolving migraine treatment landscape, an individualized treatment approach is needed. This review provides practical recommendations on how to obtain a correct diagnosis and then engage in a long-term partnership with patients with the most severe form of migraine: chronic migraine (CM). Given the need to effectively treat this complex neurological disease, clinicians in primary care, general neurologists, and headache specialists are at the forefront to ease the burden of this disease for their patients. This manuscript will review how to discuss the currently available treatment options to help control migraine attacks, manage expectations, and, together with the patient, determine the most effective and appropriate treatment. The goal is to create an environment where the clinician partners with the patient in shared decision-making to choose the most effective appropriate treatment for the individual patient.

Cost and benefit in the choice of ECT schedule

1998 ◽  
Vol 172 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Baruch Shapira ◽  
Nurith Tubi ◽  
Heinz Drexler ◽  
David Lidsky ◽  
Avraham Calev ◽  
...  
Keyword(s):  
Memory Impairment ◽  
Depression Scale ◽  
Antidepressant Effect ◽  
Hamilton Depression Scale ◽  
Cognitive Effects ◽  
Weekly Treatment ◽  
Significant Difference ◽  
Before And After ◽  
Rate Of Response

BackgroundWe compared the anti-depressant and cognitive effects of up to eight sessions of bilateral, brief pulse electroconvulsive therapy (ECT) administered twice (ECT x 2) or three times weekly (ECT x 3), to confirm that ECT x 3 acts more rapidly although the two schedules are equivalent in antidepressant outcome, and to establish whether ECT x 3 is indeed associated with more severe memory impairment.MethodPatients with major depression, endogenous subtype were randomly assigned to ECT x 3 or ECT x 2 plus one simulated ECT per week, both up to a maximum of eight real ECT. Depression was evaluated by the Hamilton Depression Scale the day after each treatment and cognitive function by a test battery administered before and after the ECT series and at one month follow-up.ResultsAssessed categorically or parametrically, there was no significant difference in antidepressant outcome between the two schedules. Rate of response was significantly more rapid with ECT x 3 but was associated with more severe memory impairment.ConclusionsTwice weekly administration is an optimum schedule for bilateral ECT unless clinical indications require the more rapid antidepressant effect of three times weekly treatment.

scholarly journals Efficacy of hyperbaric oxygen combined with escitalopram in depression and its effect on cognitive function

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Kun Mi ◽  
Qiang Guo ◽  
Bao-yan Xu ◽  
Man Wang ◽  
Hao Bi
Keyword(s):  
Cognitive Function ◽  
Hyperbaric Oxygen ◽  
Depression Scale ◽  
Control Group ◽  
Hamilton Depression Scale ◽  
Observation Group ◽  
Creative Commons ◽  
Significant Difference ◽  
Hamd Score ◽  
Icd 10

Objective: To investigate the efficacy of hyperbaric oxygen (HBO) combined with escitalopram in patients with depression and its effect on cognitive function. Methods: From 2016 to 2018, seventy patients with depression aged 18-65 years treated in Affiliated Hospital of Hebei University were selected. Seventy patients with depression meeting the diagnostic criteria of ICD-10 were selected and randomly divided into control group and observation group using a random number table, with 35 patients in each group. The control group was treated with escitalopram, while the observation group was additionally treated with HBO on this basis. The patients were assessed using the Hamilton Depression Scale (HAMD) and Montreal Cognitive Assessment Scale (MoCA) before treatment and two, four and six weeks after treatment. Results: Two weeks after treatment, HAMD score showed a statistically significant difference between the two groups (P < 0.05). No statistically significant differences were found in HAMD score between the two groups four and six weeks after treatment (P > 0.05). Four and six weeks after treatment, MoCA score presented statistically significant differences between the two groups (P < 0.05). Conclusion: Escitalopram combined with HBO in the treatment of depression presents rapid efficacy and a certain effect in improving cognitive function. doi: https://doi.org/10.12669/pjms.37.4.3993 How to cite this:Mi K, Guo Q, Xu BY, Wang M, Bi H. Efficacy of hyperbaric oxygen combined with escitalopram in depression and its effect on cognitive function. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3993 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Association Between Obesity and Post-stroke Anxiety in Patients With Acute Ischemic Stroke

2021 ◽  
Vol 8 ◽  
Author(s):  
Bei-Lei Zhu ◽  
Ai-Yi Hu ◽  
Gui-Qian Huang ◽  
Hui-Hua Qiu ◽  
Xian-Chai Hong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Abdominal Obesity ◽  
Depression Scale ◽  
Elevated Risk ◽  
Hamilton Depression Scale ◽  
Post Stroke ◽  
Significant Difference ◽  
Clinical Measurements

Post-stroke anxiety (PSA) is serious psychosomatic comorbidity among patients with stroke, but whether obesity could be positively associated with PSA is currently unknown. The purpose of this study was to investigate the potential association between obesity and subsequent anxiety risk in patients with stroke. A total of 441 patients with acute ischemic stroke (AIS) onset were consecutively recruited within 7 days, and PSA and post-stroke depression (PSD) were evaluated by using a 14-item Hamilton anxiety scale (HAMA) and 17-item Hamilton depression scale (HAMD) at the end of 1-month follow-up. The odds ratio (OR) with 95% CI was estimated for the incidental PSA by using logistic regression analysis. The incidence of PSA was 25.85% at the end of 1-month follow-up, with a significant difference between patients with and without abdominal obesity. Relative fat mass (RFM) and abdominal obesity were significantly associated with an elevated risk of PSA, and the crude ORs were 1.04 (95% CI: 1.01–1.08) and 1.93 (95% CI: 1.11–3.34), respectively. Even after adjustment for obesity-related risk factors and PSA-related clinical measurements, the association remained to be pronounced with abdominal obesity. However, RFM (OR = 1.03, 95% CI: 0.99–1.06, P = 0.053) and abdominal obesity (OR = 1.31, 95% CI: 0.80–2.15, P = 0.280) were not significantly associated with an elevated risk of PSD. Abdominal obesity was independently associated with the PSA instead of PSD, which may help predict PSA risk in clinical practice. Further prospective clinical studies with a long follow-up duration are warranted to verify this finding.

Hypericum in the Treatment of Seasonal Affective Disorders

1994 ◽  
Vol 7 (1_suppl) ◽  
pp. 29-33 ◽  
Author(s):  
B. Martinez ◽  
S. Kasper ◽  
S. Ruhrmann ◽  
H.-J. Möller
Keyword(s):  
Major Depression ◽  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Seasonal Pattern ◽  
Depression Scale ◽  
Light Condition ◽  
Light Therapy ◽  
Hamilton Depression Scale ◽  
Full Remission ◽  
Significant Difference

Seasonal affective disorder (SAD) represents a subgroup of major depression with a regular occurrence of symptoms in autumn/winter and full remission in spring/summer. Light therapy (LT) has become the standard treatment of this type of depression. Apart from this, pharmacotherapy with antidepressants also seems to provide an improvement of SAD symptoms. The aim of this controlled, single-blind study was to evaluate if hypericum, a plant extract, could be beneficial in treating SAD patients and whether the combination with LT would be additionally advantageous. Patients who fulfilled DSM-III-R criteria for major depression with seasonal pattern were randomized in a 4-week treatment study with 900 mg of hypericum per day combined with either bright (3000 lux, n = 10) or dim (< 300 lux, n = 10) light condition. Light therapy was applied for 2 hours daily. We found a significant (MANOVA, P < .001) reduction of the Hamilton Depression Scale score in both groups but no significant difference between the two groups. Our data suggest that pharmacologic treatment with hypericum may be an efficient therapy in patients with seasonal affective disorder.

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