Efficacy of Mindfulness-Based Cognitive Therapy on Headache Considering the Moderating Role of Alexithymia: A Randomized Controlled Trial

Background Mindfulness-based intervention has been found efficacious in reducing primary headaches and negative cognitive-related pain. However, little is known about the potential moderators in this regard. One of the most important moderators affecting the headaches is Alexithymia.  Objective The present study investigated the moderating role of Alexithymia on the effect of Mindfulness-Based Cognitive Therapy (MBCT) on pain intensity in patients with primary headache. Methods A clinical trial was conducted in 2017 and 2018 at Imam Hossein Hospital of Tehran City, Iran. Using judgment sampling method, of 94 inpatients with chronic headache, 85 were selected and randomly assigned into the two groups of MBCT (43 patients) and control (42 patients). The Numerical Rating Scale (NRS) of Pain Self-Efficacy Questionnaire (PSEQ) and Pain Catastrophizing Scale (PCS) were applied to collect data. The obtained data were analyzed by Independent Samples t-test and Chi-squared test; longitudinal data were analyzed using linear mixed model analysis. Findings Statistically significant time×group interactions were found for pain intensity (P<0.001), self-efficacy (P<0.001), and catastrophizing (P<0.001). The obtained results indicated a significant reduction in pain, pain catastrophizing and increased self-efficacy.  Conclusion MBCT is a potentially efficacious approach for individuals with headache. Alexithymia may have clinically relevant factors for identifying the patients who may benefit most from MBCT as a pain intervention.