Mindfulness in the treatment of chronic headache pain.

摘要

This study examined effects of mindfulness meditation training in chronic headache patients on (1) headache pain, measured by a headache log, (2) health-related quality of life, measured by three scales of the Medical Outcomes Study Short-Form Health Survey, Version 2.0 [SF-36 (2.0)], and (3) sense of control, measured by three scales of the Shapiro Control Inventory (SCI). Forty adult chronic headache pain patients were randomized into either a treatment or a waitlist control group. Each group also received treatment-as-usual from the treating neurologist. The treatment group reported a trend toward reduced headache pain compared to the control group during the seventh week of treatment ( p < .040, one-tailed). The between-groups difference was not significant after the Bonferroni correction, (which required p < .007, one-tailed to achieve significance). Concerning health-related quality of life, the treatment group demonstrated a trend toward reduction in past-week bodily pain, measured by the SF-36 (2.0) Bodily Pain scale (p < .079, one-tailed), and physical limitations due to health problems, measured by the SF-36 (2.0) Physical Functioning scale (p < .084, one-tailed), when compared to controls. The between-groups difference in past-week limitations in usual role activities due to physical health problems, measured by the SF-36 (2.0) Role-Physical scale, was not significant. Results for Bodily Pain nearly achieved significance after partialing out pre-treatment scores (p < .009, one-tailed). For sense of control, the increase was significantly greater for the treatment group on the SCI Domain Specific Sense of Control scale, which measures sense of control in 25 domains concerned with the body, mind, relationships, career, self, environment, and vices, (p < .006, one-tailed), when compared to controls. The SCI measure for self as source of control approached significance ( p < .064, one-tailed). The between-groups difference for the SCI Mode of Control: Positive Yielding scale was not significant. Since all seven males were randomized into the treatment group, all results were corrected for gender. Results suggest mindfulness meditation training may increase aspects of sense of control in female chronic headache patients. This training warrants further investigation regarding its effect on headache pain and aspects of health-related quality of life.