Posttraumatic Headache (PTH) is a very troubling disease for patients and doctors. This disease is a headache syndrome that complains of injuries to the head (brain) and neck area due to automobile accidents, various industrial accidents, battles, and injuries during military service.
Cognitive-behavioral therapy (CBT) is effective in the treatment of post-traumatic headache, which does not improve well with various treatments, a study has found.
This is the result of a study and analysis of 193 veterans (average age 39.7 years, 87% male) who participated in combat following the 9/11 terrorist attacks at the University of Texas at San Antonio, USA.
Although 80% of post-traumatic headaches are usually cured within one year, the remaining 20% must suffer from headaches as lifelong sequelae. Even with brain magnetic resonance imaging (MRI), there is nothing wrong with various tests. However, the patient complains of symptoms such as severe headache, insomnia, dizziness, neck and shoulder pain, anxiety, and panic disorder. It’s different from a typical migraine with obvious symptoms.
The results of the study showed that cognitive behavioral therapy has the potential to effectively reduce the symptoms of post-traumatic headache (PTH) and post-traumatic stress disorder (PTSD). About 40% of patients with post-traumatic headache also have post-traumatic stress disorder. However, both drug therapy and behavioral therapy generally do not work well.
The research team analyzed the effects of cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), and general therapy (TPU) for post-traumatic headache over 6 weeks. As a result, cognitive behavioral therapy was found to be more effective in the treatment of post-traumatic headache than general treatment. Cognitive processing therapy showed a significant effect in reducing post-traumatic stress disorder, but it was expensive and did not help much in improving post-traumatic headache.
Cognitive behavioral therapy is a psychological treatment therapy that helps people find new ways to act in a short time by changing the way they think. In the case of cognitive behavioral therapy, the research team focused on relieving headache-related disorders and stress through relaxation, setting goals for the activity that the patient wants to do once more, and planning for the situation.
Cognitive processing therapy is a psychological treatment therapy that helps people recover from post-traumatic stress disorder and related disorders. This includes elements of cognitive behavioral therapy. In cognitive processing therapy, the research team focused on resolving post-traumatic stress disorder through strategies to evaluate and modify unpleasant maladaptive thoughts related to trauma.
Meanwhile, general treatment includes drug therapy, pain management (including Botox injection), physical therapy, and integrated health treatment (including massage and acupuncture).
The research team evaluated the degree of pain with the score of the Headache Impact Test (HIT-6). The lowest score of HIT-6 is 36 and the highest is 78. A score of 49 or less indicates no or no headache effect, a score of 50-55 indicates a slight headache effect, a score of 56-60 indicates a significant headache effect, and a score of 60 or higher indicates a very severe headache effect.
As a result of data analysis, it was found that the HIT-6 score for post-traumatic headache of patients who received cognitive behavioral therapy decreased by an average of 3.4 points compared to patients who received general treatment. This treatment effect lasted up to 6 months. The HIT-6 score for post-traumatic stress disorder of patients who received cognitive behavioral therapy also decreased by an average of 6.5 points compared to patients who received general treatment. This treatment effect lasted up to 6 months.
In addition, the HIT-6 score for post-traumatic headache of patients who received cognitive processing therapy decreased by only 1.4 points on average compared to patients who received general treatment. The scores for post-traumatic stress disorder among patients who received cognitive processing therapy decreased by an average of 8.9 points compared to those who received general therapy.
However, the researchers found that cognitive processing therapy was significantly more expensive than cognitive behavioral therapy. In the case of cognitive behavioral therapy, the training time of a psychologist is regarding 2 hours, and the treatment time is 4-8 hours. In contrast, in the case of cognitive processing therapy, the training time of the psychologist is much longer, and the treatment time is 12 hours or more.
The study’s co-author, University of Texas Associate Professor Don McGeary (psychiatry and behavioral science) said, “This study is effective because the study was very extensive, addressing as many headache mechanisms as possible, and developed a treatment focused on function. “He said.
The results of this study (Cognitive Behavioral Therapy for Veterans With Comorbid Posttraumatic Headache and Posttraumatic Stress Disorder Symptoms) were published in JAMA Neurology and introduced by Medical News Today, a British health media.
By Kim Young-seop, staff reporter [email protected]
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