针对罹患慢性紧张型头痛员工的网络认知行为疗法与心理教育有效性的验证——随机对照试验

Background: Tension-type headaches are associated with significant socioeconomic costs through reduction of employee productivity and quality of life. The purpose of this study was to determine whether internet-computerized cognitive behavioral therapy (iCBT) was superior to psychoeducation (PE) in improving headache. Methods: After approval by the Institute Review Board, workers who gave their informed consent, who were aged 20 to 50 years with chronic tension-type headaches, were included in the study. A randomized controlled trial to compare iCBT with PE was conducted for 6 weeks. The primary outcome was the Brief Pain Inventory (BPI). The secondary outcomes were headache intensity (Headache Impact Test: HIT-6), catastrophic thinking, anxiety, depression and so on. Results: 514 participants were randomly assigned to the two groups. 399 participants (iCBT: n=141, PE: n=258) who performed at least once for 6 weeks were analyzed. There was no significant difference of BPI as the primary outcome between the two groups. As the secondary outcomes, PHQ-15 at 6 weeks and HIT-6 at 12 weeks were significantly reduced in iCBT, compared with that in PE. No significant differences of the other secondary outcomes between the two groups were found. Comparing within-group, the mean changes of BPI were significantly reduced in iCBT (-0.48) and in PE (-0.50) at 6 weeks from baseline. HIT-6 and PCS were also significantly reduced at 6 weeks from baseline in both groups. Conclusions: No significant differences were found in the primary outcome between the two intervention groups for tension-type headaches. Although the results must be interpreted with caution because of a lack of comparison with a waitlist control group or pharmacotherapy, this study suggested simple Internet-based self-help psychological interventions including iCBT and PE could act as alternatives to using drugs to improve tension-type headaches.