Bakcground & Aims: Migraine headache is known as a headache disorder and an important health problem that affects the quality of life and is one of the main causes of complications among people and one of the main consumers of health-related resources (2). Migraine is the most common neurological problem in primary care. According to the findings of the latest Global Burden of Disease study, migraine ranks second among the causes of disability in the world and among young women (4).
One of the components that are damaged in the occurrence of migraine headaches is thinking and perception. Meanwhile, cognitive distortions are irrational thoughts that cause anxiety, problems in relationships, and mental disorders (5). Cognitive distortions are multifaceted and complex concepts, cognitive distortions are negative biases in thinking that make people vulnerable to mental disorders (6). Cognitive errors are among the factors that are related to many diseases and cause changes in a person's feelings and cause tension and headaches. These errors were identified by Albert Ellis, in which the causes of mental problems are considered to be the existence of some of these errors. Errors that cause a deviation in a person's thinking and affect his daily life.
Until now, in order to better understand and more effective interventions in pain management among patients with migraine, various psychotherapy models have been considered, one of these interventions is short-term psychodynamics. Most short-term psychodynamic approaches are guided by conceptual frameworks such as the 2-triangle model and emphasize unconscious processes (thoughts, fantasies, and emotions) related to adverse life events (9). Specific controlled studies on short-term intensive psychodynamic therapy show that this treatment method is effective and economical (11-13), especially for the treatment of personality disorders (10), treatment-resistant depression (12), chronic low back pain (14), and headache and chronic migraine (10) as well as short-term intensive psychodynamics in its modified and gradual form can help treat some psychotic states (15). Reviewing the background of the research shows that in addition to the effectiveness of this treatment method, its effects on variables such as cognitive distortion in migraine headache patients have not been done, which is a gap in the present research. Therefore, the current research is looking for the question of whether short-term intensive psychodynamic therapy has an effect on reducing cognitive distortions in patients with migraine headaches?
Methods: This research was a semi-experimental study with a pre-test-post-test design with a control group. The statistical population of the research included all women with migraine who referred to the neurology and neuropsychology clinic in Tehran in the spring of 1402, in which there were 30 people as samples in two experimental (15 people) and control (15 people) groups randomly were replaced. In order to collect data, the Migraine Headache Questionnaires of Ahvaz Najarian (1376) and the Cognitive Distortions of Abdullahzadeh and Salar (1389) were used. The experimental group underwent intensive short-term psychodynamic intervention by Dovanlo (1990) for 16 sessions, but there was no intervention in the control group.
Results: The results indicated a significant difference between the post-test averages of the two experimental and control groups (p<0.05). So that covariance analysis showed that short-term intensive psychodynamic intervention reduced cognitive distortions and improved migraine headaches in migraine patients.
Conclusion: Based on the results, there is a significant difference between the post-test subjects of the control group and the experimental group in terms of the score of cognitive distortions with the pre-test control. In other words, intensive short-term psychodynamic therapy is effective in reducing cognitive distortions in patients with migraine headaches. According to the above topics and researches conducted in this field such as Rafipour et al. (1401) Caldiroli et al. better explain their needs to others, because psychotherapy sessions are presented in a precise, short-term and dynamic manner that reveals, blocks, challenges and recognizes defensive resistance (18,19). Also, the results showed that there is a significant difference between the post-test subjects of the control group and the experimental group in terms of the migraine headache score with the pre-test control. That is, 62.5% of the individual differences in the migraine headache post-test scores are related to the effectiveness of short-term intensive psychodynamic therapy, and this effectiveness is a reduction in migraine pain. French et al. (2000) show that the patient's belief in his ability to prevent or control headache predicts the degree of disability resulting from headache (21). The existing hypotheses in cognitive behavioral therapy and its effect in managing daily headaches show that the combination of drug therapy and cognitive behavioral therapy is very effective in the treatment of headaches. Cognitive behavioral therapy is very effective in reducing the excessive use of painkillers and disability caused by headaches, emotional helplessness, improving the quality of life, and most importantly, turning minor headaches into severe and debilitating headaches. Intensive and short-term dynamic psychotherapy is important not only because it resolves the symptoms of disorder and reconstruction of personality and psychiatric symptoms and illness in a very short period of time, but also because it leads to increasing the patient's capacities in continuous self-knowledge and has enough effects. Beyond the resolution of the symptoms, it will have a disorder (25). From this, it can be explained that intensive and short-term psychodynamic therapy is effective on patients' headaches. It is suggested to conduct short-term psychodynamic intervention effectiveness follow-up tests in future researches. Non-implementation of follow-up tests on research samples, use of self-report questionnaires, limitation of the statistical population to neurology and neuropsychology clinics in Tehran, and lack of cooperation of doctors in introducing patients, despite the fact that health psychology has been active in the field of pain management for many years. is one of the limitations of the present research. The results of the present study showed that short-term intensive psychodynamic therapy was effective in reducing cognitive distortions and headache symptoms in migraine patients and led to the improvement of these variables. Therefore, it is suggested that considering the effect of intensive and short-term psychodynamic therapy, counseling centers and treatment clinics, by holding short-term intensive psychodynamic educational and therapy workshops for migraine headache patients, lead to a reduction in cognitive distortion.