A Propensity Score Matching Study on the Effect of OnabotulinumtoxinA Alone versus Short-Term Psychodynamic Psychotherapy Plus Drug-of-Choice as Preventive Therapy in Chronic Migraine: Effects and Predictive Factors.

Objective: The objective of this study was to test the superiority of multidisciplinary approach, that is, Short-Term Psychodynamic Psychotherapy (STPP) plus drug of choice, versus monotherapy, that is, OnabotulinumtoxinA (OnaBoNT-A).

Method: We consecutively recorded data from chronic migraine (CM) patients, with or without medication overuse headache (MOH), who underwent STPP or OnaBoNT-A, with a 3-month follow-up schedule. Headache days and analgesics intake were monitored as primary outcome measures.

Psychotherapeutic treatments evaluated with two instruments: clinical questionnaire and semantic differential.

We evaluated about 100 psychotherapeutic treatments on the Freudian model with two independent instruments: a clinical questionnaire (assessed globally and intuitively) and a semantic differential (processed through various mathematic analyses). The results obtained with the two instruments were compared, and we also compared the semantic evolution of patients with that of normal subjects. Both instruments show an undeniable average improvement among patients.