One-day Intervention for Depression and Impairment in Migraine Patients

描述(申请人提供)：抑郁症在偏头痛患者中的发病率是普通人群的三到五倍。这种共病具有重大的公共卫生意义，因为它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，当出现抑郁症时，偏头痛的经济负担会加倍。然而，有效的治疗方法还没有得到研究。这项修订的以患者为导向的导师职业发展奖(K23)申请提出了一项培训和指导计划，重点放在精神病和疼痛共病干预研究中的两个重叠领域：1)测试“以部署为重点”的干预措施，即那些旨在促进广泛传播的干预措施，在实验过程的早期，考虑到实施限制的实际情况；以及2)探索和确定治疗反应的调解人和调解人。K23培训部分与K23培训部分相辅相成的是，管理一项随机对照试验的直接经验，评估为期1天的接受和承诺治疗加偏头痛教育(ACT-ME)与仅接受偏头痛教育(MEO)强化研讨会对患有抑郁症和偏头痛的患者的抑郁症和功能障碍的疗效。它还旨在调查治疗变化的调解人和调解人。该格式简短而创新，具有最佳治疗依从性、参与者可接受性和广泛部署到实践环境的潜力。由于这些人群的需求与仅有精神障碍的患者的需求不同，该提议至少与NIMH的两个战略目标一致， 即开发个性化的创新干预措施，以最大限度地利用患有精神疾病和疼痛问题的患者，并使用创新的服务提供方法。这项提议将为丁多博士的长期科学目标奠定坚实的基础，该目标是创建一个独立的研究计划，专注于开发务实和创新的方法，以改善患有精神疾病和疼痛的患者的心理健康和功能。这项工作将在爱荷华大学医院和诊所进行，这是一家在抑郁症治疗方面做出重大贡献的一流学术机构。

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.