Exploring Emotional Distress, Psychological Traits and Attitudes in Patients with Chronic Migraine Undergoing OnabotulinumtoxinA Prophylaxis versus Withdrawal Treatment

Abstract

This explorative cross-sectional study aims at exploring emotional distress, psychological profiles, and the attitude towards receiving psychological support in eighty-seven patients with chronic migraine (CM) undergoing OnabotulinumtoxinA prophylactic treatment (OBT-A, n = 40) or withdrawal treatment (WT, n = 47). The outcomes were explored through a specific battery of questionnaires. 25% of patients undergoing OBT-A and almost half of the patients undergoing WT reported psychological distress of at least moderate-severe level, respectively. Coping strategies, self-efficacy, and perceived social support were similar in the two groups. Patients undergoing OBT-A presented lower psychological inflexibility than patients undergoing WT. Predictors of higher psychological distress were low perceived social support by friends, low self-efficacy, and higher avoidance strategies. In both groups, most of the patients evaluated receiving psychological support to be useful (79%). The potential beneficial effects of OBT-A on the severity of symptoms and psychological distress might further support its role in the multidisciplinary management of patients with CM. Identifying patients with psychological vulnerabilities who may benefit from psychological support is relevant in patients with CM.

Health-Related Quality of Life and Psychological Features in Post-Stroke Patients with Chronic Pain: A Cross-Sectional Study in the Neuro-Rehabilitation Context of Care

“…This cross-sectional study is part of the “EXPLORE” (Exploring psychological needs of patients with chronic pain attending neurorehabilitation services) project, which arose from the collaboration between the Neurorehabilitation Unit and the Clinical Psychology Unit of the Verona University Hospital (Verona, Italy). The EXPLORE project aims at investigating the psychological distress, the psychological features, and HrQoL of patients presenting different chronic pain conditions [ 27 , 28 ].…”

“…The psychological assessment was performed in line with the EXPLORE protocol [ 27 , 28 ]. Psychological distress was measured through the Symptom Checklist-90 (SCL-90-R) scale measuring psychopathological symptoms through 90 items rated on a five-point Likert scale (from “not at all” to “extremely”) [ 35 , 36 ].…”

“…The fixed order of providing the questionnaire might be acknowledged as a possible administration bias. All the questionnaires used were validated instruments for the Italian context and already used in the context of neurological diseases [ 27 , 28 , 42 , 43 ]. The fixed administration order might have interfered in the results.…”

Rehabilitation and Biomarkers of Stroke Recovery: Study Protocol for a Randomized Controlled Trial

“…Evaluation endpoints of WP4 include incidence of psychopathology (e.g., anxiety and depression) after stroke and related pain conditions, psychopathological issues, and coping strategies affecting adherence to rehabilitation programs, effectiveness of psychopharmacological and psychotherapeutic treatments in stroke patients, definition of specific psychological interventions supporting rehabilitation ( 17 , 18 ). Accordingly, the outcomes considered are the Symptom Checklist-90 scale ( 19 ); the Eysenck Personality Questionnaire-R ( 20 ); the COPE scale ( 21 ); the General Self-Efficacy Scale ( 22 ); the Acceptance and Action Questionnaire-II scale ( 23 ); the Multidimensional Scale of Perceived Social Support ( 24 ); the Brief Pain Inventory-I scale ( 25 ).…”

The Use of Botulinum Toxin A as an Adjunctive Therapy in the Management of Chronic Musculoskeletal Pain: A Systematic Review with Meta-Analysis

“…Finally, Fos, a protein product of the gene c-fos, expressed after exposure to painful neuronal stimuli, was prevented by peripheral exposure to BoNT-A injection [ 30 ]. Altogether, this evidence suggests that BoNT-A can act on blocking peripheral sensitisation, which, in turn, may reduce central sensitisation, thus improving descended pain inhibitory control and cortical hyperexcitability [ 16 , 17 , 31 , 32 , 33 , 34 ].…”