None listed
Conditions
Brief summary
Numerous studies have demonstrated comorbidity between migraine and tension-type headache on the one hand, and depression on the other. It is not clear whether this reflects a causal relationship between headaches and depression or common predispositional factors. Presence of depression is a negative prognostic indicator for behavioral treatment of headaches. Despite the recognised comorbidity, there is limited research literature evaluating interventions designed for comorbid headaches and depression. Sixty six participants (49 female, 17 male) suffering from migraine and/or tension-type headache and major depressive disorder were randomly allocated to a Cognitive Behavior Therapy program, or a control group (Routine Primary Care). The treatment program involved 12 weekly 50-minute sessions administered by clinical psychologists. Participants in the treatment and control groups significantly differed from baseline to post-treatment on measures of headaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintained at four month follow-up. Changes in headaches and depression were not significantly correlated suggesting that the relationship between them may not be causal. Comorbid anxiety disorders were not a predictor of response to treatment, and the only significant predictor was gender (men improved more than women). The new integrated treatment program appears promising and worthy of further investigation.
Interventions
The intervention involves 12 50-minute sessions and includes: education about headaches and depression; relaxation training; scheduling pleasant activities; social skills training; training to challenge dysfunctional thoughts and underlying beliefs; problem solving training; identifying and managing headache triggers; training in pain management techniques; lifestyle management; and relapse prevention training.
Sponsors
Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Diagnosed as tension-type headache or migraine, minimum of 6 headaches per month, minimum chronicity of 12 months and pattern stable over 6 months, and diagnosed as major depressive disorder.
Exclusion criteria
Major psychiatric disorders other than anxiety disorders, factors interfering with giving informed consent or benefiting from treatment, and medical conditions with over riding treatment requirements.
Outcome results
None listed