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Behav Res Ther. 2015 Oct;73:8-18. doi: 10.1016/j.brat.2015.07.005. Epub 2015 Jul 21.

Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial.

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School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mt Gravatt Campus, 176 Messines Ridge Road, Mt Gravatt, Queensland 4122, Australia. Electronic address:
School of Psychology and Psychiatry, Monash University, Monash Medical Centre, 246 Clayton Road, Victoria 3168, Australia.
Melbourne School of Psychological Sciences, University of Melbourne, and Heidelberg Repatriation Hospital, 300 Waterdale Road, Heidelberg Heights, Victoria, 3081, Australia.
School of Health Sciences, RMIT University, PO Box 71, Bundoora, Victoria 3083, Australia; Australian College of Applied Psychology, Australia.


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. 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.


Cognitive behavior therapy; Depression; Migraine; Tension-type headache

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