Three studies of the psychologic changes in chronic headache patients associated with biofeedback and relaxation therapies.

Abstract

Three separate, but similar, studies are described in which the psychologic effects (depression, anxiety, and overall degree of psychosomatic distress) of nonpharmacologic treatment (relaxation and/or biofeedback training) for three kinds of chronic headache (tension, migraine, and mixed migraine and tension) were evaluated. Results showed consistently (across all three studies) significant reductions in depression and trait-anxiety associated with receiving treatment, regardless of headache type or treatment outcome. The significant reduction for overall degree of psychosomatic distress was not differentially related to receiving treatment and thus could have been due to prolonged monitoring of headaches or test-retest regression effects.

Chronic Pain and the Measurement of Personality: Do States Influence Traits?

“…Two studies [23,28] addressed the issue of the stability of trait anxiety with pain treatment (Table A5). Both of these studies were type III and had an overall quality score of 92.2%.…”

Tension-type headache and psychiatric comorbidity

“…Mood or anxiety disorders increase headache-related disability [17], the likelihood of treatment adherence problems [42], and quite possibly the risk of headache progression [43,44]; psychiatric disorders also deserve treatment in their own right. The treatment of TTH with either preventive drug therapy (at least the tricyclic antidepressants that have been studied) or with behavioral therapy, particularly cognitive-behavioral therapy [45][46][47][48][49], appears to improve, although not necessarily eliminate, symptoms of anxiety and depression. With behavioral headache therapies, reductions in psychological symptoms do not appear to be simply a function of improvements in tension headaches [46,47].…”

“…The treatment of TTH with either preventive drug therapy (at least the tricyclic antidepressants that have been studied) or with behavioral therapy, particularly cognitive-behavioral therapy [45][46][47][48][49], appears to improve, although not necessarily eliminate, symptoms of anxiety and depression. With behavioral headache therapies, reductions in psychological symptoms do not appear to be simply a function of improvements in tension headaches [46,47]. In contrast, reductions in psychological symptoms with tricyclic antidepressant therapy may be primarily a function of improvements in tension head-aches, with the antidepressant and anti-anxiety effects of tricyclics emerging only at higher doses than typically used for TTH [50][51][52].…”

Hypnotic Relaxation Vs Amitriptyline for Tension‐Type Headache: Let the Patient Choose

“…[12][13][14] Such non-pharmacological interventions also improve depression, anxiety, and psychosomatic parameters. 15,16 Recent comparative studies have shown that relaxation techniques are as effective as AMT in alleviating TTH. 9,17,18 Indeed, relaxation and behavioral techniques such as biofeedback, cognitive behavioral therapy, and meditation have been empirically validated for migraine and TTHs, with meta-analyses yielding 37% to 60% reductions in TTH, 17,18 comparing favorably with the 33% reduction with AMT.…”