The online version of this article (doi:10.1186/1129-2377-15-81) contains supplementary material, which is available to authorized users.
The research received grants from Lundbeck (R67-A6507) and the Danish “Helsefonden” (2099B033).
DK received honoraria and travel funding from Allergan and Pfizer. HBF, TWT and RHJ have not received any funding relating to this study. RHJ is a board member of EHMTIC, EHF, LTB, ATI, Linde Gas and Neurocore.
DK, HBF and RHJ conceived the study, and participated in its design and coordination. DK included the patients, conducted the study and drafted the manuscript. TWT supervised the statistical analyses. HBF, RHJ and TWT revised the manuscript critically. All authors read and approved the final manuscript.
Chronic post-traumatic headache (CPTH) after mild head injury can be difficult to manage. Research is scarce and successful interventions are lacking.
To evaluate the effect of a group-based Cognitive Behavioural Therapy (CBT) intervention in relation to headache, pain perception, psychological symptoms and quality of life in patients with CPTH.
Ninety patients with CPTH according to ICHD-2 criteria were enrolled from the Danish Headache Center into a randomized, controlled trial. Patients were randomly assigned to either a waiting list group or to a nine-week CBT group intervention. At baseline and after 26 weeks all patients completed the Rivermead Post Concussion Symptoms Questionnaire, SF-36, SCL-90-R and a headache diary.
The CBT had no effect on headache and pressure pain thresholds and only a minor impact on the CPTH patients’ quality of life, psychological distress, and the overall experience of symptoms. The waiting-list group experienced no change in headache but, opposed to the treatment group, a significant decrease in somatic and cognitive symptoms indicating a spontaneous remission over time.
Our primarily negative findings confirm that management of patients with CPTH still remains a considerable challenge. Psychological group therapy with CBT might be effective in an earlier stage of CPTH and in less severely affected patients but our findings strongly underline the need for randomized controlled studies to test the efficacy of psychological therapy.
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- Cognitive behavioural treatment for the chronic post-traumatic headache patient: a randomized controlled trial
Hysse B Forchhammer
Thomas W Teasdale
Rigmor H Jensen
- Springer Milan
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