PREVENTIVE THERAPY OF CHRONIC MIGRAINE IN PATIENTS WITH COMORBID ANXIETY AND DEPRESSION
The research purpose is to evaluate the effectiveness of the complex preventive treatment of chronic migraine on common comorbidities including depression and anxiety. Materials and methods. 97 people with chronic migraine were examined. Neurological examination, headache diary analysis, questionnaire testing were performed. The main group of patients received complex therapy, including botulinum therapy in combination with relaxation training. The control group of patients received botulinum therapy according to the PREEMPT protocol for chronic migraine. When analyzing the results, we identified 2 subgroups of patients depending on the nature of comorbid psychoemotional disorders. The first subgroup consisted of patients with comorbid anxiety and depression, the second - with comorbid anxiety. Results and its discussion. In patients with comorbid anxiety, complex treatment has reduced the level of anxiety from high to moderate. A decrease in the level of depression according to the Beck scale from severe depression to its absence was achieved with the use of complex treatment. The use of relaxation in patients with anxiety reduced the frequency of headaches from 20 to 11 days a month after 30 days of therapy. The use of relaxation in patients with anxiety reduced the frequency of headaches from 20 to 11 days a month after just 30 days of therapy. Complex therapy allowed to reduce the HIT - 6 index from 62 to 47 points (p=0.004). The complex therapy of CM made it possible to reduce the severity of psychosomatic manifestations according to the Giessen questionnaire in patients with concomitant depression and anxiety from 77.8 to 50 points (p=0.002). Conclusion. The use of complex therapy of CM, can significantly reduce the level of psychoemotional disorders in patients with chronic migraine.