CBT for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial

Abstract

Numerous studies have demonstrated comorbidity between migraine and tension-type headache on the one hand, and depression on the other. Presence of depression is a negative prognostic indicator for behavioral treatment of headaches. Despite the recognised comorbidity, there is a limited research literature evaluating interventions designed for comorbid headaches and depression. research blog (2)Sixty six participants (49 female, 17 male) suffering from migraine and/or tension-type headache and major depressive disorder were randomly allocated to a Routine Primary Care control group or a Cognitive Behavior Therapy group that also received routine primary care. The treatment program involved 12 weekly 50-min sessions administered by clinical psychologists. Participants in the treatment group improved significantly more than participants in the control group from pre-to post-treatment on measures of headaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintained at four month follow-up. 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.

 

Martin, P. R., Aiello, R., Gilson, K., Meadows, G., Milgrom, J., & Reece, J. (January 01, 2015). Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial. Behaviour Research and Therapy, 73, 8-18.

CBT plus Medication is Effective for Chronic Migraine in Children and Adolescents

According to a recent study published in JAMA, cognitive behavior therapy (CBT) plus amitriptyline (a tricyclic antidepressant used in the treatment of migraines) may be an effective treatment for chronic migraines in children and adolescents. In the current study, researchers compared the efficacy of CBT plus amitriptyline versus headache education plus amitriptyline. Participants included 135 youth aged 10 to 17 diagnosed with chronic migraine. They were randomized to either the CBT plus amitriptyline group (n = 64) or headache education plus amitriptyline group (n = 71). Participants received either 10 CBT sessions or 10 headache education sessions involving equivalent time and therapist attention. At post-treatment, 66% in the CBT group had at least a 50% reduction in headache days versus 36% in the headache education group. At the 12-month follow up, 86% in the CBT group had at least a 50% reduction in headache days versus 69% in the headache education group. These findings support the efficacy of CBT in the treatment of chronic migraine among children and adolescents.

Powers, S. W., Kashikar-Zuck, S. M., Allen, J. R., LeCates, S. L., Slater, S. K., Zafar, M., Kabbouche, M. A., … Hershey, A. D. (December 25, 2013). Cognitive Behavioral Therapy Plus Amitriptyline for Chronic Migraine in Children and Adolescents. Jama, 310, 24, 2622.