Do cognitive behavioral therapies for posttraumatic headache and posttraumatic stress disorder (PTSD) symptoms improve headache-related disability in veterans compared with treatment per usual?
Headache-related disability and PTSD symptom severity improved with cognitive behavioral therapy compared with usual care in United States military veterans with posttraumatic headache and PTSD, according to a study in JAMA Neurology.
A randomized clinical trial of 193 post-9/11 combat veterans with posttraumatic headache and PTSD symptoms found headache disability was significantly improved with cognitive behavioral therapy for headaches compared with treatment per usual. Though participants randomly assigned to cognitive processing therapy reported significantly greater improvement in PTSD symptom severity compared with treatment per usual, there was no significant effect of cognitive processing therapy on headache disability.
The present study examined 2 nonpharmacological interventions for PTH in military veterans with persistent headache related to comorbid mTBI and clinical PTSD symptoms. Investigators compared a manualized behavioral headache intervention, cognitive behavioral therapy for headache (CBTH), and a manualized PTSD intervention, cognitive processing therapy (CPT), with usual care in a sample of US military veterans with mTBI-related headache. CBTH uses cognitive behavioral therapy concepts with documented effects for headache disability and comorbid mood in primary headaches, and CPT has produced significant improvements in PTSD and related health symptoms (including headaches). We hypothesized that both CBTH and CPT would result in significant improvement in both headache-related disability and PTSD symptom severity compared with usual care in veterans with PTH attributable to mTBI and comorbid clinical PTSD symptoms.
“Veterans are more likely than civilians to develop [posttraumatic headache (PTH)] after [mild traumatic brain injury], and mechanisms of PTH are poorly understood,” Donald D. McGeary, PhD, of the department of psychiatry and behavioral sciences at the University of Texas Health Science Center at San Antonio, and colleagues wrote. “Manualized cognitive behavioral therapies offer safe, broad-spectrum treatment for PTH, but limited evidence supports their use.”
Check out the study here.