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.
Numerous studies have demonstrated comorbidity between migraine and tension-type headache on theone hand, and depression on the other. Presence of depression is a negative prognostic indicator forbehavioral treatment of headaches. Despite the recognised comorbidity, there is a limited researchliterature 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 depressivedisorder were randomly allocated to a Routine Primary Care control group or a Cognitive BehaviorTherapy 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 improvedsignificantly more than participants in the control group from pre-to post-treatment on measures ofheadaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintainedat 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 newintegrated treatment program appears promising and worthy of further investigation.
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