An integrated approach to cephalalgic patients. Preliminary results on 64 adult patients with migraine without aura

摘要

The importance of the neuropsychological aspect in patients affected by tension headache is highlighted by different data in the literature as well as the results of a multicentric Italian study on comorbidity linked to consistent pathologies, from psychiatric to psychopathologies, in cephalalgic subjects. The need for an integrated approach to the treatment of migraine comes from the assumption, which has recently been confirmed by research, that cephalalgic patients, depending on their emotional condition, have difficulty in dealing with anxiety or other forms of stress in their everyday life. An integrated intervention is extremely useful both in the diagnostic and in the therapeutical approach. For 6 months, 64 patients with migraine without aura were subjected to an integrated therapeutical approach (the median age was 39 years). A number of exclusion criteria were used. The first group comprised 34 patients with migraine without aura having fewer than 4 attacks per month, while the second group comprised 30 patients with migraine without aura having more than four attacks per month. The psychological intervention involved clinical colloquia, such as Jacobson’s muscle relaxation technique as well as tests and clinical questionnaires (follow-up and discussion). The follow-up assessed parameters relative to the attacks: frequency, length, and intensity. The reduction in the frequency and the length of migraine was more evident in the groups undergoing an integrated approach than in the group undergoing pharmacological therapy. This reduction was more significant in the group (8 patients) with more than four episodes per month, whose treatment involved an integrated approach and Jacobson’s relaxation technique. The integrated approach yielded better results in patients with higher frequency, length, and elevated intensity of attacks (>4 attacks/month).