Long-term effects of training in relaxation and stress-coping in patients with migraine: a 3-year follow-up.

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.