The role of stress and psychiatric comorbidities as targets of non-pharmacological therapeutic approaches for migraine
The role of stress and psychiatric comorbidities as targets of non-pharmacological therapeutic approaches for migraine
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DOI：
10.1708/3457.34458
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发表时间：
2020-09-01
影响因子：
2.7
通讯作者：
Tarsitani, Lorenzo
中科院分区：
文献类型：
--
作者：
Pancheri, Corinna;Maraone, Annalisa;Tarsitani, Lorenzo
这种叙述性的审查地址之间的相互联系压力，精神障碍和偏头痛与特定的重点非药物干预，可能是有效的改善偏头痛和精神并发症。偏头痛常与抑郁、焦虑、人格障碍和睡眠障碍共病。主观压力和压力源是偏头痛发作的常见触发因素，也是慢性化的风险因素，而精神障碍和压力反应则以双向关系密切相关。最近的研究表明，精神科合并症与偏头痛的严重程度，更糟糕的结果，增加残疾和降低生活质量。发表了许多关于偏头痛非药物干预的研究，行为治疗包括生物反馈、认知行为治疗、放松训练、压力管理和简短的精神动力学心理治疗。总之，心理干预被证明是有效的偏头痛治疗和药物和心理治疗的组合似乎比药物或心理治疗更有效。非药物干预的有效性应是由于偏头痛、应激相关易感性和精神障碍的改善共同作用，联合治疗可预防偏头痛的慢性化回路。需要设计良好的长期研究来阐明非药物技术在治疗和预防偏头痛中的比较有效性。
This narrative review addresses the interconnections among stress, mental disorders and migraine with a specific focus on non-pharmacological interventions that may be effective in improving both migraine and the psychiatric comorbidity. Migraine is often comorbid with depression, anxiety, personality disorders, and sleep disorders. Subjective stress and stressors are common triggers for migraine attacks and are risk factors for chronification, whilst mental disorders and stress responses are closely linked in a bidirectional relation. Recent studies show that psychiatric comorbidity is associated with migraine severity, worse outcomes, increased disability and reduce quality of life. Numerous studies on non-pharmacological interventions for migraine were published and behavioural treatments included biofeedback, cognitive-behavioural therapy, relaxation training, stress management and brief psychodynamic psychotherapy. Taken together, psychological interventions proved to be effective in migraine treatment and a combination of pharmacological and psychological treatment appear to be more effective than either medication or psychotherapy alone. Non-pharmacological interventions effectiveness should be due to the improvement of migraine, stress-related vulnerability and mental disorders together and the combined treatment could prevent the chronification circuit of migraine. Well-designed long-term studies are needed to clarify comparative effectiveness of non-pharmacological techniques in the treatment and the prevention of migraine.