Treatment for Migraine and Mood (Team-M)

Phase 2

Completed

Brief Summary: The researchers propose a two-arm pilot study of telephone and video delivered Mindfulness-based Cognitive Therapy (MBCT-T and MBCT-V) in people with migraine and depressive symptoms.

Detailed Description: This study aims to set the stage for a future definitive large-scale Phase III trial in patients with migraine and depressive symptoms. This first phase is aimed at fidelity optimization of MBCT-T and MBCT-V in people with migraine (defined by the International Classification of Headache Disorders - 3) and depressive symptoms (defined by empirical cut-offs on the Patient Health Questionnaire - 9).

Recruitment & Eligibility

Inclusion Criteria

Currently meets ICHD-3 criteria for migraine using the Structured Diagnostic Interview for Headache
Self-reported 4-14 headache days per month, with at least one attack meeting migraine criteria
Score between 5-14 on the PHQ-9
Age ≥ 18
Ability to read and speak English
Capacity to consent

Exclusion Criteria

Meeting ICHD-3 criteria for persistent headache attributed to traumatic injury to the head (post-traumatic headache) on the Structure Diagnostic Interview for Headache
Changes in preventive migraine medication or anti-depressant medication within 6 weeks of intake; changes in longer-term migraine prevention (onobotulinum toxin A, anti-calcitonin gene related peptide treatment) within 3 months of intake
Comorbid psychiatric illness or clinical features that would interfere with participant's ability to participate in or receive benefit from the MBCT intervention, including but not limited to: active suicidal ideation; recent history of psychosis or mania; borderline, histrionic or narcissistic personality disorder; cognitive impairment; sensory disabilities
Prior history of engaging in formal mindfulness-based interventions including: MBSR, MBCT, Acceptance and Commitment therapy, Dialectical Behavior Therapy
Current meditation practice >3x/week

Arm && Interventions

Group	Intervention	Description
MBCT-T (Mindfulness-Based Cognitive Therapy - Telephone)	MBCT-Telephone	Mindfulness-based cognitive therapy delivered by Telephone
MBCT-V (Mindfulness-Based Cognitive Therapy - Video)	MBCT-Video	Mindfulness-based cognitive therapy delivered by Video

Primary Outcome Measures

Name	Time	Method
Homework Assignment Completion Rate	Week 8	Defined as the proportion of assigned home-based practice that participants completed each week.
Treatment Session Adherence Rate	Week 8	Treatment Session Adherence is a measure of treatment feasibility and is defined as the number of scheduled treatments that were attended by the participants. This measure will be assessed through electronic monitoring of the attendance logs of each treatment session. A treatment arm will be considered feasible if participants attended/read 75% of sessions on average.
Average Client Satisfaction Questionnaire Score (CSQ-8)	Week 8	The CSQ-8 is an 8-item generic standardized self-report tool to measure satisfaction with health and human services received by individuals and families. An overall score is calculated by summing the respondent's rating (item rating) score for each scale item. For the CSQ-8 version, scores range from 8 to 32, with higher values indicating higher satisfaction. A threshold score of greater than or equal to 24 is the cut-off for "Acceptability."
Mean Score on MBCT-T/V Adherence & Competence Scales (MBCT-TACS)	Week 8	The mindfulness-based cognitive therapy (MBCT)-TACS is an assessment of treatment fidelity in terms of adherence and competence. The scores per session are recorded between 0-3 and averaged to get the total score. The total range of score is 0-3; the higher the score, the higher the fidelity.