Rational emotional behavior therapy in the treatment of migraine

Lifa WANG; Guangming DAI; Chunguo FEI

ABSTRACT

BACKGROUND:

Nervousness, anxiety and depression are important inducing factors of migraine, while nervousness, anxiety and depression are closely correlated with the unreasonable belief and incorrect strategy. Medicine therapy is the principal method in the treatment of migraine at present, but it cannot change the unreasonable belief of the patients and thereby to reducethe occurrence of the inducing factors of headache.

OBJECTIVE:

To observe the near term and long term therapeutic effects of medicine therapy and rational emotional behavior therapy(REBT) to provide a safer and more effective intervention for the patients with migraine and thereby to improve their long term quality of life(QOL).

DESIGN:

An observatory comparative study based on patients with migraine as subjects and healthy population as controls.

SETTING:

A psychological consultation clinic of a municipal hospital(has been canceled now).

PARTICIPANTS:

Totally 86 cases of migraine including 34 males and 52females aged between 16 and 48 years old(means of 35 years old) with a course of disease between 2 and 11 years were selected from the Psychological Consultation Clinic of the 289 Hospital between March 1999 and October 2001. All 86 cases were randomly divided into REBT group and medicine group with 43 cases each. There was no significant difference of age, gender,course of the disease, situation of the disease, and education background between two groups. Another 30 healthy individuals including 12 males and 18 females with a mean age of 36 years old were selected in control group.

METHODS:

REBT was applied for patients in REBT group. Patients of medicine group received 50-100 mg/day of Amitriptyline and 60 mg/day of nimodipine through oral administration. Patients received 12 weeks of therapy followed by 24 weeks of observation.MAIN OUTCOME

MEASURES:

Therapeutic scale score on migraine (TSSM), before and after migraine-correlated potential(P300) and symptoms checklist 90 (SCL-90) scores were compared.

RESULTS:

SCL-90 total points of two groups of patients were significantly higher than that of control group( P ＜ 0.05); after 12 weeks of therapy,TSSM, SCL-90 total points and points of major factors of two groups of patients were significantly lower compared with the situations before therapy( P ＜ 0.05), but there was no significant difference between two therapy groups; on the 12th week after therapy, SCL-90 total points, points for major factors and TSSM, and P300 latency of REBT group were almost as the same as that after 12 weeks of therapy and the wave amplitude of P300 significantly elevated; owever, the differences in SCL-90 total points, points of major factors, and the TSSM in medicine group were significant compared with that after 12 weeks of therapy( P ＜ 0.05) . There was significant difference at the same period between two therapy groups ( P ＜ 0.05).

CONCLUSION:

REBT can reduce the attacks of migraine, decrease TSSM,and has similar therapeutic effects to medicine group. Simultaneously, it can ameliorate the cognitive disorder, change the unreasonable belief of the patients, and improve the strategy to cope with the disease; hence its long term therapeutic effect is better than medicine therapy.