Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial
Section snippets
Design
The study employed a split-plot ANOVA design, consisting of one between-subjects factor (Group), and one within-subjects factor (Time). A randomization procedure based on the CONSORT guidelines was used to allocate participants to a treatment group (CBT for recurrent headache and comorbid depression) or control group (routine primary care, RPC). General considerations in the study design were to maximize practicability of the intervention studied for uptake in routine practice by typical
Participant characteristics
Demographic and clinical characteristics of the sample are shown in Table 1. Occupations have been classified according to the Australian and New Zealand Standard Classification of Occupations. One type of headache was identified for 20 participants and two types for 46 participants. The headache diagnoses in Table 1 are the primary diagnoses. Anxiety disorders were diagnosed in 47 participants, and a total of 96 anxiety disorders were identified. Posttraumatic Stress Disorder and Specific
Conclusions
The CBT program was associated with a significant reduction in headaches, and the decrease was significantly different from the RPC control group. The latter finding is unique as the only previous trial of an integrated treatment for comorbid headaches and depression failed to find a significant difference between headache changes in the treatment and control groups (Dindo et al., 2014). The reason for the different findings between the studies is not clear but the two studies did use quite
Acknowledgements
This research was supported by a grant from beyondblue Victorian Centre of Excellence, an initiative of beyondblue and the Victorian Government, administered through Monash University. Thanks to Crown House Publishing for giving permission to use a relaxation CD, as described in the text. Thanks to David Reutens, Leon Piterman, Martin Sharman, Lillian Nejad and Alex Wynd for contributions to the research, and to the clinical psychologists who provided treatment in this study.
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2021, Journal of Psychiatric ResearchCitation Excerpt :In analogy, previous evidence on MDD and comorbid chronic pulmonary disease proved effectivity of MDPs in reducing both depressive and respiratory symptoms, while focusing on overcoming barriers of treatment and promoting adherence to medication and healthier lifestyle (Alexopoulos et al., 2013). In depressed migraineurs, CBT led to reductions of headache and depressive symptoms simultaneously (Martin et al., 2015), supporting the obvious benefits of MDP, and CBT in particular, for MDD with comorbid somatic diseases. An auspicious finding in this context is that different formats of CBT, including group and remote interventions, that are more cost-effective and better accessible than individual therapies, seem to exhibit similar effects (Kamenov et al., 2017), and could therefore be preferably applied to a broader patient population including individuals who are potentially disadvantaged in terms of socio-demographic, economic and/or disease factors.