One-day Intervention for Depression and Impairment in Migraine Patients

描述（由申请人提供）：偏头痛患者中抑郁症的发生率是一般人群的三到五倍。这种合并症具有重大的公共卫生意义，因为它会导致生活质量和总体预后下降，并增加自杀和残疾的风险。重要的是，偏头痛带来的经济负担在抑郁症患者中会翻倍。然而，有效的治疗方法尚未被研究。这一修订后的以患者为导向的指导职业发展奖（K23）申请提出了一个培训和指导计划，重点关注精神病学和疼痛共病干预研究中的两个重叠领域：1)测试“以部署为中心”的干预措施，即那些旨在通过在实验过程的早期考虑到实施限制的实际现实来促进广泛传播的干预措施；2)治疗反应的调节因子和调节因子的探索和鉴定。K23培训部分由直接经验管理的随机对照试验补充，评估为期1天的强化工作坊接受和承诺治疗加偏头痛教育（ACT-ME）与偏头痛教育（MEO）对抑郁症和偏头痛共病患者的抑郁和损害的疗效。它还旨在研究治疗改变的介质和调节因子。该格式简短而创新，提供了最佳治疗依从性、参与者可接受性和广泛部署到实践环境的潜力。由于这一人群的需求不同于那些仅患有精神疾病的患者，该提议至少与NIMH的两个战略目标是一致的，

DESCRIPTION (provided by applicant): Depression is three to five times more common among migraine patients than in the general population. This comorbidity is of major public health significance as it results in decreased quality of life and overall prognosis and increased risk for suicidality and disability. Importantly, the economic burden of migraine doubles when there is depression. Yet, effective treatments have not been investigated. This revised Patient-Oriented Mentored Career Development Award (K23) application proposes a training and mentorship plan focused on two overlapping areas within interventions research for psychiatric and pain comorbidity: 1) testing interventions that are "deployment-focused," i.e., those designed to facilitate broad dissemination by taking into account, early on in the experimental process, the practical realities of implementation constraints; and 2) the exploration and identification of mediators and moderators of treatment response. The K23 training component is complemented by direct experience administering a randomized controlled trial assessing the efficacy of an intensive 1-day workshop of Acceptance and Commitment Therapy plus Migraine Education (ACT-ME) versus Migraine Education Only (MEO) for depression and impairment in patients suffering from comorbid depression and migraine. It also aims to investigate mediators and moderators of therapeutic change. The format is brief and innovative, offering potential for optimal treatment adherence, participant acceptability, and broad deployment to practice settings. Since the needs of this population are different from those of patients with only psychiatric disorders, the proposal is consistent with at least two of NIMH's strategic objectives, namely developing innovative interventions, personalized for optimal use in patients with comorbid psychiatric and pain problems, and using innovative service delivery approaches. This proposal will provide a solid foundation for Dr. Dindo's long-term scientific goal of creating an independent program of research focused on developing pragmatic and innovative ways to improve the mental health and functioning of patients suffering from comorbid psychiatric and pain conditions. The work will be conducted at the University of Iowa Hospitals and Clinics, a premiere academic institution with major contributions to the treatment of depression.