Psychologische Therapie der Migräne

Der Schmerz - Tập 27 - Trang 263-274 - 2013
G. Fritsche1, B. Kröner-Herwig2, P. Kropp3, U. Niederberger4, G. Haag5
1Neurologische Klinik, Universität Essen, Essen, Deutschland
2Klinische Psychologie und Psychotherapie, Universität Göttingen, Göttingen, Deutschland
3Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
4Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
5Michael-Balint-Klinik, Königsfeld, Deutschland

Tóm tắt

Dieses Review fasst zusammen, für welche verhaltenstherapeutischen Behandlungen der Migräne die Wirksamkeit empirisch nachgewiesen werden konnte. Die wichtigsten unimodalen Verfahren sind das thermale und das Elektromyographie(EMG)-Biofeedback-Training sowie die progressive Muskelrelaxation. Die verschiedenen Entspannungstechniken unterscheiden sich in ihrer Wirkung bei Migräne nicht. Im Mittel wird eine Reduktion der Migränehäufigkeit von 35–45 % erreicht. Die mittleren Effektstärken (ES) verschiedener Biofeedback-Techniken hinsichtlich der Schmerzreduktion der Migräne liegen zwischen 0,4 und 0,6. Als multimodales Verfahren kommt das kognitiv-behaviorale Schmerzbewältigungstraining zur Anwendung. Es erzielt im Mittel eine Verbesserung der Migräneaktivität von 39 % und eine ES von 0,54. Alle verhaltenstherapeutischen Einzelverfahren können ergänzend oder alternativ zur medikamentösen Prophylaxe mit vergleichbarem Erfolg eingesetzt werden. Eine Kombination aus pharmakologischer und verhaltenstherapeutischer Behandlung kann einen zusätzlichen Erfolg erzielen. Im Kindes- und Jugendalter finden sich deutliche Evidenzen für eine klinisch relevante Wirksamkeit aller verhaltenstherapeutischen Verfahren. Differenzielle Indikationshinweise gibt es nicht.

Tài liệu tham khảo

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