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Pain Med. 2004 Jun;5(2):178-86.

Cognitive-behavioral group treatment for disabling headache.

Author information

1
Centers for Behavioral and Preventive Medicine, Brown Medical School and The Miriam Hospital, Lifespan Academic Medical Center, Providence, Rhode Island 02903, USA. Justin_Nash@Brown.edu

Abstract

OBJECTIVES:

Severe, disabling headache is costly to individual sufferers, through pain and reduced functioning, and to society, through decreased work productivity and increased health care use. First-line prophylactic agents combined with triptans do not adequately benefit many disabled headache sufferers. We sought to investigate whether a cognitive-behavioral treatment targeting the psychological and behavioral factors that contribute to disabling headache may provide additional benefit and whether using a group format may provide a more intensive clinic-based treatment without increasing the cost of service delivery.

DESIGN:

We developed and piloted a cognitive-behavioral group treatment for chronic, disabling headache. We evaluated its effectiveness in decreasing headache, reducing symptomatic medication use, and improving quality of life.

SETTING:

A behavioral headache management program of an academic medical center.

PATIENTS:

Sixty-two individuals suffering from primary headache disorder with moderate to severe headache-related disability who completed treatment.

INTERVENTIONS:

Individuals completed a pretreatment evaluation, the 10-session cognitive-behavioral group treatment, and a 1-month-posttreatment evaluation.

OUTCOME MEASURES:

The impacts of treatment on headache (frequency, intensity, and duration), medication use, and quality of life were assessed.

RESULTS:

Separate multivariate analyses of variance revealed significant improvements in headache, symptomatic medication use, and quality of life. Overall, 50% of participants experienced at least a 50% reduction in headache frequency from pre- to posttreatment.

CONCLUSIONS:

The findings provide preliminary evidence that delivering a clinic-based, group-format cognitive-behavioral treatment to moderately to severely disabled headache sufferers can decrease headache activity, reduce symptomatic medication use, and improve quality of life.

PMID:
15209972
PMCID:
PMC2882886
DOI:
10.1111/j.1526-4637.2004.04031.x
[Indexed for MEDLINE]
Free PMC Article

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