Cognitive Neurodynamics

, Volume 13, Issue 2, pp 183–189 | Cite as

An open/pilot trial of cognitive behavioral therapy in Turkish patients with refractory chronic migraine

  • Ozge Sahmelikoglu Onur
  • Devrimsel Harika Ertem
  • Cagatay Karsidag
  • Derya Uluduz
  • Aynur Ozge
  • Aksel Sıva
  • Meltem GuruEmail author
Research Article


Cognitive behavioral therapy (CBT) for pain management is a therapy that aims to modify thoughts and behavior to be more realistic and balanced. There are limited number of studies to assess the efficacy of CBT for patients with pharmacotherapy-resistant chronic migraine in our population. We aimed to invstigate the effects of CBT for patients with refractory chronic migraine on pain attack frequency, disability, severity, anxiety and depression. Fourteen patients with refractory chronic migraine who were referred from the headache clinic to the psychiatry department and regularly attended CBT sessions at least once every 2 weeks for at least 6 months, were included in the study. After 2 sessions of psychiatric evaluation, the subjects had 12 40-min CBT sessions and were given relaxation exercises. The Hamilton depression and anxiety inventories, visual analogue scale for assessing the severity of pain, and the Migraine disability assessment (MIDAS) test were used before and after CBT. The mean Hamilton depression scores before and after CBT were 29.07 ± 7.74 and 14.21 ± 7.7, respectively (p < 0.0001). The mean Hamilton anxiety scores before and after CBT were 26.8 ± 11.7 and 11.7 ± 2.6, respectively (p < 0.0001). The mean VAS scores before and after CBT were 8.07 ± 0.91 and 3.71 ± 1.32, respectively (p < 0.0001). The mean MIDAS scores before and after CBT were 55.5 ± 20.4 and 20.12 ± 16.6, respectively (p < 0.0001). Our results showed that CBT had made a statistically significant difference on pain severity, number of migraine attacks and disability in patients with refractory chronic migraine. CBT should be considered in this patient group.


Anxiety Cognitive behavioral therapy Depression Disability Migraine 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of PsychiatryBakirkoy Research and Training Hospital for Psychiatry Neurology and NeurosurgeryIstanbulTurkey
  2. 2.Department of AlgologySisli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
  3. 3.Department of Neurology, Cerrahpasa Faculty of MedicineIstanbul UniversityIstanbulTurkey
  4. 4.Department of NeurologyMersin University School of MedicineMersinTurkey
  5. 5.Department of PsychiatryGazi University Health Care CenterAnkaraTurkey

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