title: Depression, automatic thoughts, alexithymia, and assertiveness in patients with tension-type headache.
abstract: OBJECTIVE
  The role of psychological factors related to headache has long been a focus of investigation. The aim of this study was to evaluate depression, automatic thoughts, alexithymia, and assertiveness in persons with tension-type headache and to compare the results with those from healthy controls.
  
  
  METHODS
  One hundred five subjects with tension-type headache (according to the criteria of the International Headache Society classification) and 70 controls were studied. The Beck Depression Inventory, Automatic Thoughts Scale, Toronto Alexithymia Scale, and Rathus Assertiveness Schedule were administered to both groups. Sociodemographic variables and headache features were evaluated via a semistructured scale.
  
  
  RESULTS
  Compared with healthy controls, the subjects with headache had significantly higher scores on measures of depression, automatic thoughts, and alexithymia and lower scores on assertiveness. Subjects with chronic tension-type headache had higher depression and automatic thoughts scores than those with episodic tension-type headache.
  
  
  CONCLUSIONS
  These findings suggested that persons with tension-type headache have high depression scores and also may have difficulty with expression of their emotions. Headache frequency appears to influence the likelihood of coexisting depression.
authors.affiliation: Department of Psychiatry, University of Istanbul, Istanbul, Turkey.
authors.forename: Basak
authors.initials: B
authors.lastname: Yücel
authors.forename: Kaan
authors.initials: K
authors.lastname: Kora
authors.forename: Süleyman
authors.initials: S
authors.lastname: Ozyalçín
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Alçalar
authors.forename: Ozay
authors.initials: O
authors.lastname: Ozdemir
authors.forename: Aysen
authors.initials: A
authors.lastname: Yücel
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology*; D001242:Assertiveness; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D018781:Tension-Type Headache / Q000523:psychology*; D013850:Thinking