Sorbi M, Tellegen B, Du Long A
Headache. 1989 Feb;29(2):111-21. doi: 10.1111/j.1526-4610.1989.hed2902111.x.
Research on the short-term effects of psychological interventions in migraine indicates improvement rates of 50 percent. Yet long-term follow-ups are scarce: the studies extending to three years provide evidence for the maintenance of effects, but these studies evaluate the benefits of rather complex psychological treatments and the samples include other types of headache. We compared the effects of single-method psychological interventions upon migraine. The study reports results obtained from 24 patients three years after completion of relaxation training, which is a psychophysiological regimen, and stress-coping training, which is a cognitive-behavioral regimen. Results for the complete sample, excluding data biased by confounding factors, provide clear evidence of the preservation of effects in migraine. Relaxation training (RT) and stress-coping training (SCT) were equally effective and both groups exhibited little medication consumption since completion of training. Among the secondary effects, SCT was found to improve assertiveness and active problem solving, and to decrease depressive reaction. The study yielded two predictor variables--little external stress for relaxation training, and high self motivation for stress-coping training--that accounted for more than 50 percent of the effect variance in the respective groups. Although more research is needed to substantiate our findings, the results suggest that, thus far, there is little reason to favor multimodal training or more complex psychological treatments over single-method psychological interventions in migraine. Also, our results do not support the assumed superiority of cognitive-behavioral treatment over psychophysiological treatment. Research on factors predicting long-term effects of psychological interventions in migraine may profit from considering separate variables on skill rehearsal and skill employment (instead of employing a global measure of home practice), and from a measure for post-training external stress.
偏头痛心理干预短期效果的研究表明改善率为50%。然而长期随访却很稀少：那些长达三年的研究为效果的维持提供了证据，但这些研究评估的是相当复杂的心理治疗的益处，而且样本中还包括其他类型的头痛。我们比较了单一方法心理干预对偏头痛的效果。该研究报告了24名患者在完成放松训练（一种心理生理疗法）和压力应对训练（一种认知行为疗法）三年后的结果。排除混杂因素造成偏差的数据后，完整样本的结果为偏头痛效果的维持提供了明确证据。放松训练（RT）和压力应对训练（SCT）同样有效，自训练完成后两组的药物消耗量都很少。在次要效果方面，发现SCT能提高自信和积极解决问题的能力，并减少抑郁反应。该研究得出了两个预测变量——放松训练时外部压力小，以及压力应对训练时自我动机高——这两个变量在各自组中占效果变异的比例超过50%。尽管需要更多研究来证实我们的发现，但结果表明，到目前为止，在偏头痛治疗中，没有什么理由更倾向于多模式训练或更复杂的心理治疗而不是单一方法心理干预。此外，我们的结果不支持认知行为治疗优于心理生理治疗的假设。对偏头痛心理干预长期效果预测因素的研究，可能得益于考虑技能演练和技能运用方面的单独变量（而不是采用家庭练习的总体测量方法），以及训练后外部压力的测量方法。
