Biofeedback treatment for headaches, Raynaud's disease, essential hypertension, and irritable bowel syndrome: a review of the long-term follow-up literature.

Long-term follow-up evidence for biofeedback treatment of headaches, Raynaud's disease, essential hypertension, and the irritable bowel syndrome was reviewed. Acknowledging the difficulties with cross-study comparisons, the following general success rate were determined: primary idiopathic Raynaud's disease--70%, or better; vascular headache--70%, or better; mixed headache--about 60%; and muscle contraction headache--50%, or less. With relatively fewer patients, successful outcomes with the irritable bowel syndrome and secondary Raynaud's phenomenon were roughly 60% and 40%, respectively. Few cases of clinically significant long-term decreases in diastolic blood pressure were demonstrated; however, the need for medication was reduced or eliminated in some patients. There were indications that biofeedback combined with psychotherapy resulted in highest success rates. No differences were found in effectiveness between biofeedback, other relaxation techniques, and biofeedback in combination with relaxation techniques--all had essentially comparable rates of success. No correlations between physiological and psychological measures of condition at follow-up were reported. Implications and interpretations of these findings are discussed.