Department of Psychiatry, Catholic university of Daegu, School of Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, Republic of Korea.
Department of Biostatistics, Korea University Graduate School, Seoul, South Korea.
J Headache Pain. 2019 Feb 14;20(1):17. doi: 10.1186/s10194-019-0965-4.
Headache disorder is not only a common complaint but also a global burden. Pharmacotherapeutic and non-pharmacotherapeutic approaches have been developed for its treatment and prophylaxis. The present study included a systematic review of psychological treatments for primary headache disorder accessible in Korea.
We included English and Korean articles from EMBASE, MEDLINE, Cochrane library database, SCOPUS, ScienceDirect, Web of Science, CINAHL, PsycArticles and Korean database, KoreaMed and KMBASE which studied primary headache and medication-overuse headache. The primary efficacy measure was the number of headache days per month, while secondary efficacy measures were the number of headache attacks per week, headache index, treatment response rate, and migraine disability assessment. The meta-analysis was performed using R 3.5.1. to obtain pooled mean difference and pooled relative risk with 95% confidence interval (CI) for continuous data and dichotomous data, respectively.
From 12,773 identified articles, 27 randomized clinical trials were identified. Primary outcome showed significant superiority of psychological treatments (pooled mean difference = - 0.70, 95% CI [- 1.22, - 0.18]). For the secondary outcomes, the number of headache attacks (pooled mean difference = - 1.15, 95% CI [- 1.63, - 0.67]), the headache index (pooled mean difference = - 0.92, 95% CI [- 1.40 to - 0.44]) and the treatment response rate (pooled relative risk = 3.13, 95% CI [2.24, 4.37]) demonstrated significant improvements in the psychological treatment group over the control group.
Psychological treatments for primary headache disorder reduced headache frequency and the headache index. Future research using standardized outcome measures and strategies for reducing bias is needed.
头痛障碍不仅是一种常见的主诉，也是一种全球性的负担。已经开发出了药物和非药物治疗方法来治疗和预防头痛障碍。本研究对韩国可获得的原发性头痛障碍的心理治疗进行了系统评价。
我们纳入了 EMBASE、MEDLINE、Cochrane 图书馆数据库、SCOPUS、ScienceDirect、Web of Science、CINAHL、PsycArticles 和韩国数据库 KoreaMed 和 KMBASE 中的英文和韩文文章，这些文章研究了原发性头痛和药物过度使用性头痛。主要疗效指标是每月头痛天数，次要疗效指标是每周头痛发作次数、头痛指数、治疗反应率和偏头痛残疾评估。使用 R 3.5.1 进行荟萃分析，以获得连续数据和二分类数据的合并均数差和合并相对风险，置信区间（CI）分别为 95%。
从 12773 篇确定的文章中，确定了 27 项随机临床试验。主要结局显示心理治疗具有显著优势（合并均数差 = - 0.70，95%CI [-1.22，-0.18]）。对于次要结局，头痛发作次数（合并均数差 = - 1.15，95%CI [-1.63，-0.67]）、头痛指数（合并均数差 = - 0.92，95%CI [-1.40 至-0.44]）和治疗反应率（合并相对风险 = 3.13，95%CI [2.24，4.37]），心理治疗组较对照组有显著改善。
心理治疗原发性头痛障碍可减少头痛频率和头痛指数。需要使用标准化结局措施和减少偏倚的策略进行未来的研究。
