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2016 ; 263
(12
): 2369-2377
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Psychological interventions for migraine: a systematic review
#MMPMID27159991
Sullivan A
; Cousins S
; Ridsdale L
J Neurol
2016[Dec]; 263
(12
): 2369-2377
PMID27159991
show ga
Migraine causes major health impairment and disability. Psychological
interventions offer an addition to pharmacotherapy but they are not currently
recommended by the National Institute of Clinical Excellence (NICE) or available
in the National Health Service. We aimed to systematically review evidence on the
efficacy of psychological interventions for migraine in adults. A search was done
of MEDLINE, psychINFO, http://www.opengrey.eu , the meta-register of controlled
trials and bibliographies. Twenty-four papers were included and rated
independently by two people using the Yates scale, which has 35 points. Cochrane
recommendations are that high quality reports score above the mid-point (18
points). Methods used in 17/24 papers were rated 'high quality'. However,
frequently descriptions of key areas such as randomisation methods were omitted.
Eighteen studies measured effects of psychological interventions on
headache-related outcomes, fifteen reporting significant improvements, ranging
20-67 %. Interventions also produced improvements in psychological outcomes. Few
trials measured or reported improvement in disability or quality of life. We
conclude that evidence supports the efficacy of psychological interventions in
migraine. Over half of the studies were from the USA, which did not provide
universal health care at the time of the study, so it is difficult to generalise
results to typical populations in receipt of publically funded health services.
We agree with the NICE recommendation that high quality pragmatic randomised
controlled trials are needed in the UK.
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