O049. Psychodynamic functioning in chronic headache patients: a short term psychodynamic psychotherapy (STPP) study.

Massimiliano Toscano,Barbara Petolicchio,Arianna Sirolli,Edoardo Vicenzini,Edmond Gilliéron,Vittorio Di Piero,Romina Di Giambattista,Sara Aielli,Alessandro Viganò,Martina Squitieri

doi:10.1186/1129-2377-16-s1-a105

Abstract

Background Chronic headache (CM) occurs in 2-5% of the general population, often associated with medication-overuse headache (MOH), and comorbid psychiatric disorders [1,2]. Among therapeutic approaches, psychotherapeutic interventions may be effective, either alone or associated with pharmacological therapies. As we previously showed, the short-term psychodynamic psychotherapy (STPP), plus drug therapy, is more effective in patients with probable MOH to reduce headache symptoms and relapse rate than drug therapy alone [3]. Moreover, STPP alone is not inferior to valproate in CM, as preventive therapy [4]. According to psychodinamic diagnosis (BPI) some psychodynamic profiles with poor ability to process the emotional content or low mentalizing level (i.e., pre-psychosis, psychosis and borderline) could be at risk of developing chronic headaches. The aim of the present study was to identify the most frequent psychodynamic profiles in CM and test the effective of STPP in those patients with no record of psychiatric disorders.

Highlights

Chronic headache (CM) occurs in 2-5% of the general population, often associated with medication-overuse headache (MOH), and comorbid psychiatric disorders [1,2]
The protocol of psychotherapy reckoned on a first evaluation with 4 Brief Psychodynamic Investigation (BPI) and psychotherapy treatment over the subsequent 2 months
40% (n=23) of patients completed the full treatment period with a significant improvement of disease parameters (33% less attack duration, 17% less pain intensity, 41% lowering in MIDAS score, and 93% less medication overuse)

Summary

Introduction

Chronic headache (CM) occurs in 2-5% of the general population, often associated with medication-overuse headache (MOH), and comorbid psychiatric disorders [1,2]. Psychotherapeutic interventions may be effective, either alone or associated with pharmacological therapies. The short-term psychodynamic psychotherapy (STPP), plus drug therapy, is more effective in patients with probable MOH to reduce headache symptoms and relapse rate than drug therapy alone [3]. According to psychodinamic diagnosis (BPI) some psychodynamic profiles with poor ability to process the emotional content or low mentalizing level (i.e., pre-psychosis, psychosis and borderline) could be at risk of developing chronic headaches. The aim of the present study was to identify the most frequent psychodynamic profiles in CM and test the effective of STPP in those patients with no record of psychiatric disorders

Objectives

Results

Conclusion