Behavioral medicine for chronic headache: Overview and practical tools for the practicing physician

CONTINUUM Lifelong Learning in Neurology

Volumn 12, Issue 6, 2006, Pages 235-258

  Lake III, Alvin E ^a,b  

^a Michigan Head Pain and Neurological Institute   (United States)

^b Chelsea Community Hospital   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANALGESIC AGENT; BARBITURIC ACID DERIVATIVE; CAFFEINE; DECONGESTIVE AGENT; IBUPROFEN; OPIATE DERIVATIVE; PARACETAMOL; TRIPTAN DERIVATIVE;

AEROBIC EXERCISE; BECK DEPRESSION INVENTORY; BEHAVIOR THERAPY; BEHAVIORAL SCIENCE; CHRONIC DAILY HEADACHE; COGNITIVE THERAPY; COMORBIDITY; COPING BEHAVIOR; DISEASE SEVERITY; DRUG INDUCED HEADACHE; FAMILY THERAPY; FEEDBACK SYSTEM; HEADACHE; HUMAN; MENTAL DISEASE; PATIENT SATISFACTION; PERSONALITY DISORDER; PRIMARY CARE EVALUATION OF MENTAL DISORDERS; PROGNOSIS; PSYCHOMETRY; RATING SCALE; RELAPSE; RELAXATION TRAINING; REVIEW; RISK FACTOR; SMOKING CESSATION; TECHNIQUE; TREATMENT INDICATION; TREATMENT OUTCOME;

EID: 33749460731     PISSN: 10802371     EISSN: None     Source Type: Journal    
DOI: 10.1212/01.CON.0000290513.57505.b2     Document Type: Review

References (38)

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edition. DSM-IV. Washington, DC: American Psychiatric Association, 1994. Complete descriptions of current criteria for psychiatric diagnosis.
2. Ball R, Steer RA. Mean Beck Depression Inventory-II scores of outpatients with dysthymic or recurrent-episode major depressive disorders. Psychol Rep 2003;93:507-512. Helpful norms for using this commonly used depression screening measure to identify the two most common forms of clinical depression.
3. Bigal ME, Rapoport AM, Sheftell FD, et al. Transformed migraine and medication overuse in a tertiary headache centre - clinical characteristics and treatment outcomes. Cephalalgia 2004;24:483-490. Recent large-scale study in well-respected tertiary headache practice.
4. Breslau N, Davis GC. Migraine, physical health and psychiatric disorder: a prospective epidemiologic study in young adults. J Psychiatr Res 1993;27:211-221. Seminal epidemiological study of migraine and psychiatric comorbidity.
5. Breslau N, Davis GC, Schultz LR, et al. Joint 1994 Wolff Award Presentation. Migraine and major depression: a longitudinal study. Headache 1994;34:387-393. Seminal paper tracking emergence of migraine and major depression over time.
6. Chabriat H, Danchot J, Michel P, et al. Precipitating factors of headache. A prospective study in a national control-matched survey in migraineurs and nonmigraineurs. Headache 1999;39:335-338. Large headache-diary study of prevalence of common migraine triggers.
7. Chochinov HM, Wilson KG, Enns M, et al. "Are you depressed?" Screening for depression in the terminally ill. Am J Psychiatry 1997;154:674-676. Empirical study of several brief depression screens, underscoring the validity of simple, direct interview questions in identifying depression.
8. De Benedittis G, Lorenzetti A, Pieri A. The role of stressful life events in the onset of chronic primary headache. Pain 1990;40:65-75. Retrospective study showing a significant increase in major life stressors during the year prior to headache onset compared with the previous 4 years. In contrast, life changes were relatively stable over a comparable 5-year period for a control group of patients with nonheadache neurological disorders.
9. Feine JS, Lavigne GJ, Dao TT, et al. Memories of chronic pain and perceptions of relief. Pain 1998;77:137-141. Study comparing pain diary data and patient recollection of pain, identifying common distortions in pain memory.
10. French DJ, Holroyd KA, Pinell C, et al. Perceived self-efficacy and headache-related disability. Headache 2000;40:647-656. Construction and validation of a brief measure of headache-related self-efficacy to assess the extent to which headache patients believe that their own actions can control headache. Patients with higher self-efficacy report less headache-related disability.
11. Grazzi L, Andrasik F, D'Amico D, et al. Behavioral and pharmacologic treatment of transformed migraine with analgesic overuse: outcome at 3 years. Headache 2002;42:483-490. Controlled study demonstrating better long-term outcome for medication overuse patients who were withdrawn from analgesics and then received both prophylactic pharmacotherapy and biofeedback training than for those who received pharmacotherapy alone.
12. Guidetti V, Galli F, Fabrizi P, et al. Headache and psychiatric comorbidity: clinical aspects and outcome in an 8-year follow-up study. Cephalalgia 1998;18:455-462. Presence of two or more psychiatric disorders in adolescence or young adulthood predicts poor headache prognosis over time.
13. Haynes R, Yao X, Degani A, et al. Interventions to enhance medication adherence. Cochrane Database Syst Rev 2005;4:CD000011. Update of 1996 report. Simple interventions are relatively successful in increasing adherence over the short term. Effective long-term interventions are typically complex, combining a number of factors. Better adherence may be associated with better clinical outcomes, although this is not always the case.
14. Haynes RB, McKibbon KA, Kanani R. Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications. Lancet 1996;348:383-386. Systematic intervention can improve adherence over the short and long term, although even the most effective interventions often fail to lead to substantial gains in adherence.
15. Holroyd KA, O'Donnell FJ, Stensland M, et al. Management of chronic tension-type headache with tricyclic antidepressant medication, stress management therapy, and their combination: a randomized controlled trial. JAMA 2001;285:2208-2215. Randomized, controlled study showing best outcome for combination of stress management therapy and tricyclic antidepressants at 8-months follow-up.
16. Katsarava Z, Muessig M, Dzagnidze A, et al. Medication overuse headache: rates and predictors for relapse in a 4-year prospective study. Cephalalgia 2005;25:12-15. Disappointingly high relapse rates following detoxification and alternative preventive treatment. More than 40% of patients relapsed within 1 year. Relapse rate at 4 years was higher for analgesic overuse (71%) than ergots (27%) and triptans (21%).
17. Koseoglu E, Akboyraz A, Soyuer A, et al. Aerobic exercise and plasma beta endorphin levels in patients with migrainous headache without aura. Cephalalgia 2003;23:972-976. Aerobic exercise reduces migraine activity and increases plasma beta endorphin levels in adherent patients, although no relationship was found between changes in plasma beta endorphin and headache improvement.
18. Lake AE 3rd. Behavioral and nonpharmacologic treatments of headache. Med Clin North Am 2001;85:1055-1075. Practical review of behavioral treatment, with assessment and treatment suggestions including use of behavioral analysis in interviewing. Also outlines a suggested five-dimension multiaxial framework for assessment and treatment of the headache patient: I. headache diagnosis, frequency, severity; II. medication use, overuse, misuse; III. behavioral and stress-related risk factors; IV. psychiatric comorbidity, including both clinical syndromes and personality disorders; V. functional impact and disability.
19. Lake AE 3rd, Rains JC, Penzien DB, et al. Headache and psychiatric comorbidity: historical context, clinical implications, and research relevance. Headache 2005;45:493-506. Reviews current state of the research literature, with suggestions for further research.
20. Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders. J Anxiety Disord 2006;20:444-458. Empirical study of sensitivity and specificity of the Beck Anxiety Inventory for generalized anxiety, phobias, panic disorders, and obsessive-compulsive disorder with nonpsychiatric control group. Strongest quality of the Beck Anxiety Inventory is its ability to identify and assess panic symptomatology.
21. Lipton RB, Bigal ME, Kolodner K, et al. The family impact of migraine: population-based studies in the USA and UK. Cephalalgia 2003;23:429-440. Large-scale epidemiological study uncovering family impact of migraine.
22. Mao J. Opioid-induced abnormal pain sensitivity: implications in clinical opioid therapy. Pain 2002;100:213-217. Seminal, classic review of evidence that opioids can actually increase pain sensitivity in pain patients (not limited to headache).
23. Marlowe N. Self-efficacy moderates the impact of stressful events on headache. Headache 1998;38:662-667. Patients with high self-efficacy are more effective at reducing the impact of stressful events.
24. Merikangas KR, Merikangas JR, Angst J. Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res 1993;27:197-210. Multigenerational study of psychiatric comorbidity, identifying an anxiety-depression-migraine syndrome across generations, suggesting a genetic linkage of these three disorders.
25. Payne TJ, Stetson B, Stevens VM, et al. The impact of cigarette smoking on headache activity in headache patients. Headache 1991;31:329-332. Headache clinic study showing that smokers have more headache activity than nonsmokers. Among smokers, amount of daily consumption, pack-year history, and preferred cigarettes with higher nicotine content were all associated with higher headache activity.
26. Rains JC, Penzien DB, McCrory DC, et al. Behavioral headache treatment: history, review of the empirical literature, and methodological critique. Headache 2005;45:S92-S109. Recent review of meta-analyses of outcome of behavioral treatments with evidence of efficacy as solo therapies and combined with pharmacotherapy.
27. Rainville P, Doucet JC, Fortin MC, et al. Rapid deterioration of pain sensory-discriminative information in short-term memory. Pain 2004;110:605-615. Experimental study showing that retrospective pain ratings, even after very short delays, may be rather inaccurate but relatively reliable.
28. Rait DS. The therapeutic alliance in couples and family therapy. J Clin Psychol 2000;56:211-224. Reviews issues in the therapeutic alliance, including triangles in relationships, and outlines therapeutic strategies for effective management of alliances.
29. Saper JR, Hamel RL, Lake AE 3rd. Medication overuse headache (MOH) is a biobehavioural disorder. Cephalalgia 2005;25:545-546. Distinguishes between simple and complex MOH, underscoring importance of attending to behavioral factors that may drive this disorder.
30. Saper JR, Lake AE 3rd. Borderline personality disorder and the chronic headache patient: review and management recommendations. Headache 2002;42:663-674. Overview of borderline personality, recent research related to both psychological and physiological etiology of the disorder, with practical suggestions for both behavioral and pharmacological management of borderline patients in clinical practice.
31. Saper JR, Silberstein SD, Gordon CD, et al. Handbook of headache management: a practical guide to diagnosis and treatment of head, neck, and facial pain. 2nd ed. Philadelphia: Williams & Wilkins, 1999. Practical, concise, paperback handbook for the practicing physician. Includes brief discussion of cephalgiaphobia, a term perhaps first used by Harvey Featherstone, MD, to describe the obsessive fear of headache that may prompt preemptive overuse of analgesic medication.
32. Scher AI, Lipton RB, Stewart W. Risk factors for chronic daily headache. Curr Pain Headache Rep 2002;6:486-491. Review of risk factors for chronic daily headache including both clinic-based and population-based epidemiological studies.
33. Scher AI, Stewart WF, Ricci JA, et al. Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain 2003;106:81-89. Major population-based epidemiological study of chronic daily headache identifying risk factors for prevalence at baseline, as well as a prospective analysis of factors associated with the emergence of or transformation to chronic daily headache during the 11 months between the first and second interviews.
34. Smith R. Impact of migraine on the family. Headache 1998;38:423-426. First published large-scale epidemiological study of the impact of migraine on family members.
35. Sorbi MJ, Maassen GH, Spierings EL. A time series analysis of daily hassles and mood changes in the 3 days before the migraine attack. Behav Med 1996;22:103-113. Statistical time series analysis applied to individual headache diaries reveals significant time lag correlations between sleep disturbance, hassles, psychological arousal, and a subsequent migraine 1 to 3 days later. Patients differ in the time lag and strength of the correlation.
36. Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272:1749-1756. Outlines the use of this simple and efficient checklist to screen for psychiatric comorbidities in patients presenting for treatment with medical problems.
37. Suchman AL, Markakis K, Beckman HB, et al. A model of empathic communication in the medical interview. JAMA 1997;277:678-682. Presents a simple, practical model for empathic reflection of the underlying emotional tone of patient complaints as a means of enhancing the yield from interview data and identifying possible psychiatric comorbidities.
38. Tiemens BG, Ormel J, Jenner JA, et al. Training primary-care physicians to recognize, diagnose and manage depression: does it improve patient outcomes? Psychol Med 1999;29:833-845. Training physicians in depression recognition and management can improve clinical outcomes, particularly in cases of recent-onset depression.