Effectiveness of Behavior Management Intervention in Migraine With a Focus on Comorbid Depressive Symptoms

Background: Migraine negatively affects sufferers’ physical and mental health and social and economic status. Objectives: This study compared the effectiveness of behavior management therapy and pharmacotherapy in reducing migraine-related disabilities with and without focusing on comorbid depressive symptoms. Materials & Methods: This quasi-experimental study has a pre-test-post-test design with a control group. The study was conducted on migrainous patients with comorbid depressive symptoms referred to neurology clinics in Rasht City, Iran, in ۲۰۲۱. A total of ۱۸ female patients were selected using purposive sampling based on neurological diagnosis and the diagnostic and statistical manual of mental disorders (DSM-۵) criteria for depressive disorder. The participants were randomly assigned to two groups after matching regarding age and severity of depression. Combined therapy (behavior management intervention [BM] and pharmacotherapy [P]) was performed in two groups during eight sessions, with (case group) and without (control group) focusing on comorbid depressive symptoms. The data were collected using the Beck depression inventory (BDI-II), the headache disability inventory (HDI) , and the headache diary (HD) and analyzed using multivariate analysis of covariance. Results: The first therapeutic approach was significantly superior to the second in reducing migraine-related disabilities (F(۲, ۱۳)=۱۰.۴۳, P<۰.۰۵, Wilks Lambda=۰.۳۸۴, partial Ƞ۲=۰.۶۱۶). Conclusion: Combined therapy (BM & P) focusing on comorbid depressive symptoms can be an alternative or complementary therapeutic method to reduce various disabilities in migraine patients.