Introduction
Methods
Selection criteria
Search strategy
Quality assessment
Results
# | Study | Diagnosis (sample size) | Intervention | Duration | Control | Outcome measures | Quality | Percentage change in daily self-report headache frequency from baseline to endpoint, when reported (duration of follow up) |
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CBT
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1 | Thorn et al. [17] | Migraine/TTH (34) | Group CBT | 10 weeks (10× 1.5 h sessions) | Wait-list | Headache frequency, intensity (diary); psychological variables (BDI, BAI, PCS, PASS, HMSE) | 22/35 (63 %) | −8 % non-significant (none: post-intervention only) |
Relaxation therapy
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2 | Devineni and Blanchard [18] | Migraine/TTH (156) | Internet based relaxation training | 6 weeks | Wait-list | Headache index (diary), HSQ; psychological variables (CES-D, STAI); Disability (HDI) | 17/33 (52 %) | N/Aa
|
3a | D’Souza et al. [19] | Migraine/TTH (140) | Written emotional disclosure or audiotape relaxation training | 2 weeks (4 sessions) | Unemotional writing | Headache frequency (diary + retrospective) severity (retrospective); Disability (MIDAS); SCL-90R | 18/33 (55 %) | Relaxation: −42 % Written emotional disclosure: +19 % non-significant (3 months) |
3b | Kraft et al. [20] | Migraine (90) | As above | As above | As above | Headache frequency, MPQ; psychological measures (EAC, HMSE, PANAS); Disability (HDI) | 12/33 (36 %) | N/Ab
|
4 | Dittrich et al. [21] | Migraine (30) | Exercise + relaxation | 6 weeks (12× 1 h sessions) | Information giving | Headache frequency, intensity (retrospective); Psychological variables (BDI, FKB-20), QoL (PLC) | 11/35 (31 %) | N/Ac
|
5 | Varkey et al. [22] | Migraine (91) | Physio led relaxation training | 3 months (6 sessions) | Exercise or topiramate | Headache frequency, days, intensity, medication (diary); QoL (MsQoL) | 26/35 (74 %) | −23 % (6 months) |
Biofeedback
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6 | Vasudeva et al. [23] | Migraine (40) | Biofeedback-assisted relaxation | 12 weeks (12× 50 min sessions) | Self-relaxation | Cerebral blood flow velocity, headache index (log sheets), psychological variables (BDI, STAI-S) | 14/35 (40 %) | N/Aa
|
7 | Kang et al. [24] | Migraine (32) | Biofeedback-assisted autogenic training | 4 weeks (8× 50 min sessions) | Simple biofeedback | Headache index (diary), MPQ, CGI-S; psychological variables (HAM-A, HAM-D, STAI-S) | 15/35 (43 %) | N/Aa
|
CBT + relaxation therapy
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8 | Lemstra et al. [25] | Migraine (84) | Exercise, stress management lecture, relaxation therapy lecture, massage therapy | 6 weeks | Wait-list | Headache frequency, intensity, medication consumption (retrospective); psychological variables (BDI); disability (PDI); QoL (visual analogue scale) | 22/35 (63 %) | N/Ac
|
9 | Andersson et al. [26] | Migraine/TTH (44) | Internet based self-help + therapist phone call | 6 weeks (6× modules + 6× 20 min phone call) | Internet based self-help only | Headache index, frequency, intensity (diary); psychological variables (HADS, CSQ, PSS); disability (HDI) | 17/33 (52 %) | +1 % non-significant (none: post-intervention only) |
10a | Mérelle et al. [27] | Migraine (129) | Group based behavioural training delivered by lay trainers | 10 weeks (7× 2 h sessions) | Wait-list | Headache frequency, intensity (diary); psychological variables (HSLC, HMSE); QoL (MSQoL); disability (MIDAS); SF-36 | 25/35 (71 %) | −21 % (none: post-intervention only) |
10b | Mérelle et al. [28] | Migraine (129) | As above | As above | As above | As above | 26/35 (74 %) | −29 % (6 months) |
11 | Fritsche et al. [29] | Migraine (182) | Bibliotherapy + minimal-contact behavioural therapy delivered by psychotherapists | 5 weeks (5× 2 h sessions) | Bibliotherapy | Medication intake days, headache days, intensity (diary); psychological variables (HADS, CPAQ, KKG, PRSS); disability (diary) | 23/35 (66 %) | −24 % (12–24 months) |
12a | Hedborg and Muhr [30] | Migraine (83) | Internet based MBT | 6 months | Self-relaxation | Headache days (diary); psychological variables (MADRS-S); QoL (PQ23) | 18/33 (55 %) | (Significant decrease but no raw data provided) |
12b | Hedborg and Muhr [31] | Migraine (83) | As above | As above | As above | Medication consumption, efficacy (diary) | 16/33 (48 %) | N/Ab
|
13 | Bromberg et al. [32] | Migraine (213) | Internet based ‘pain ACTION’ | 4 weeks (8× 20 min sessions) | Treatment as usual | Psychological variables (CPCI-42, HSES, PCS, HSLC, DASS-21); disability (MIDAS); PGIC | 25/33 (76 %) | N/Aa
|
Biofeedback + relaxation therapy
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14 | Kaushik et al. [33] | Migraine (192) | Biofeedback + home based relaxation therapy | 6 months (10× sessions of biofeedback) | Propranolol | Headache resurgence rate, frequency, intensity, index (daily self-report); physiological variables; well-being (visual analogue scale) | 20/35 (57 %) | −52 % (6 months) |
15 | Mullally et al. [34] | Migraine/TTH (64) | Biofeedback + relaxation therapy delivered by a pain clinician | 6 weeks (10× 50 min sessions of biofeedback) | Relaxation alone | Headache frequency (retrospective) medication consumption | 12/35 (34 %) | N/Ac
|
CBT + relaxation therapy + biofeedback
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16 | Martin et al. [35] | Migraine/TTH (64) | CBT + relaxation training delivered by psychologists, or temporal pulse biofeedback | 8 weeks (8× 1 h sessions) | Wait-list | Headache ‘rating’ (daily cards); psychological variables (CAI, CSI, HSES, HSLC) | 20/35 (57 %) | N/Aa
|
17a | Holroyd et al. [36] | Migraine (232) | Beta blocker/placebo + behavioural management (workbook, audio lessons, migraine management sessions delivered by psychologists, home based biofeedback) | 4 months (4× 1 h sessions of migraine management, 10× audio lessons) | Beta blocker/placebo alone | Headache frequency, characteristics, medication use (diary); QoL (MSQoL) | 27/35 (77 %) | Behavioural management + Beta-blocker: −67 % (12 months) Behavioural management + placebo: −48 % (12 months) |
17b | Seng and Holroyd [37] | Migraine (176) | As above | As above | As above | Psychological variables (HMSE, HSLC) | 27/35 (77 %) | N/Ab
|
17c | Seng and Holroyd [38] | Migraine (177) | As above | As above | As above | Headache frequency, characteristics (diary); Disability (HDI); QoL (MSQoL) | 25/35 (71 %) | N/Ab
|
Miscellaneous
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18 | Calhoun and Ford [39] | Migraine (43) | Behavioural sleep instructions | N/A | Placebo instruction | Headache frequency, index (diary) | 13/35 (37 %) | −28 % (12 weeks) |
19 | Wachholtz and Pargament [40] | Migraine/TTH (92) | Meditation | 2 weeks (20 min/day) | Muscle relaxation | Headache days, severity (diary); Psychological measures (PANAS, STAI, HMSE); QoL (MSQoL); spiritual measures | 21/35 (60 %) | −37 % (none: post-intervention only) |