title: Neuroticism, depression and pain perception in migraine and tension-type headache.
abstract: OBJECTIVE
  People with migraine and tension-type headache (TTH) have psychiatric comorbidities. We aimed to test differences in mental health constructs by type and frequency of primary headache and associated pain sensitivity.
  
  
  METHODS
  Data on headache features, neuroticism (Eysenck Personality Questionnaire) and depression (Major Depression Inventory) were obtained from 547 individuals classified into chronic (≥15) or episodic (<15 headache days/month) and into pure migraine (n=43), pure tension type headache (TTH, n=97), migraine and TTH (n=83) and no headache diagnosis (controls, n=324) groups. A pericranial total tenderness score (TTS) and pressure pain thresholds (PPTs) were measured. Differences in mental health constructs were examined by headache frequency and type using generalized linear mixed models adjusting for sociodemographic covariates.
  
  
  RESULTS
  Depression scores were highest among people with chronic headache, lower in those with episodic headache, and lowest in controls. The chronic and episodic headache groups had higher neuroticism scores than controls. Mental health construct scores were highest for the migraine and TTH group and lowest in the control group. TTS and cephalic PPTs were correlated with neuroticism and depression and were higher in the chronic headache group compared to the no headache group even when adjusted for neuroticism and depression.
  
  
  CONCLUSIONS
  Neuroticism and depression scores are associated with headache frequency (chronic vs episodic) and are highest for migraine and TTH followed by pure TTH then migraine. Mental health constructs were correlated with but did not influence differences in TTS and PPTs between headache groups.
authors.affiliation: Department of Neurology, New York University School of Medicine, NYU Langone Medical Center and NYU Lutheran Headache Center, New York, NY, USA.|Danish Headache Center, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark.
authors.forename: S
authors.identifier: http://orcid.org/0000-0003-3973-6640
authors.initials: S
authors.lastname: Ashina
authors.affiliation: Danish Headache Center, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Bendtsen
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine and Montefiore Headache Center, Bronx, NY, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Buse
authors.affiliation: Unit for Quality and Patient Safety, Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: A C
authors.initials: AC
authors.lastname: Lyngberg
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine and Montefiore Headache Center, Bronx, NY, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Lipton
authors.affiliation: Danish Headache Center, Department of Neurology, University of Copenhagen, Rigshospitalet Glostrup, Glostrup, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Jensen
mesh_terms: D000328:Adult; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology; D000075384:Neuroticism; D058748:Pain Perception; D018781:Tension-Type Headache / Q000175:diagnosis* / Q000453:epidemiology
keywords: chronic headache; depression; migraine; neuroticism; pain threshold; tenderness; tension-type headache