Anxiety and Depression in Tension-Type Headache: A Population-Based Study

Unhealthy mental states have become common among teachers recently. Subjective physical symptoms are more likely to appear more readily than mental symptoms. In this study, we revealed that the relationship between mental states and subjective physical fatigue or pain in seven body sites among 2449 teachers. The 12-item General Health Questionnaire (GHQ-12) was used to assess mental state. We defined a score of 4 points and over in the GHQ-12 score as unhealthy mental state. We also asked about the presence of subjective physical fatigue or pain in each seven body sites in the past one year. In the results, 30.3% unhealthy mental states were found in females and 22.9% in males. Most of subjective physical fatigue or pains were detected in neck and shoulder, eyes, head and low back. Using multivariate logistic regression, higher scores in the GHQ-12 were positively associated with presence of subjective fatigue or pain in head and eyes in both genders, in lower extremities among females, and in back, upper extremities among males. Our results suggest that physical symptoms in specific body sites with gender differences may be useful in the early identification of unhealthy mental states among teachers. We should have efforts to pay attention to mental states among high school teachers if their symptoms do not get better after taking physical care.

Background: The aim of this study was to determine the influence of moderate depression determined based on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs) Axis II on the bioelectrical resting activity of temporal muscles and masseter muscles. Methods: The research participants were 68 healthy adult women. Of these, 46 people h (mean age: 22 ± 1 year) who had no temporomandibular disorders were selected for the research. They were divided based on results from RDC/TMDs (Axis II: scale’s measurement) into the study group with a moderate level of depression (23 people), rest of participants without symptoms of depression were classified to control group (23 people). The resting activity of temporal muscles and masseter muscles was examined by using BioEMGIII electromyograph. Two statistical analyses were used: Shapiro–Wilk test and Mann–Whitney U test. Results: Despite higher mean tensions of temporal muscles and masseter muscles in the group with depression, results findings were not statistically significant (p > 0.05). Conclusions: Moderate depression determined based on the RDC/TMDs II axis questionnaire is not related to the resting activity of selected masticatory muscles. Further research should be continued on a larger group of respondents in order to establish the relationship between psychological factors and bioelectrical parameters of the masticatory muscles.

INTRODUCTIONHeadache occurs with number of psychiatric disorders, including depressive disorders, anxiety disorders, posttraumatic and stress-related disorder. There is always a common causative factors and reciprocal influence between headache and psychiatric disorders. Psychological and psychopathological analysis discloses the genesis of the headache mostly the psychological, social and occupational stressors which play an important role for the transformation of migraine into chronic one. Most recent studies also report that stress-related disorders and post-traumatic stress disorders are closely associated with migraine . One theory strongly suggest that migraine and psychiatric comorbidity share the common genetic factors, serotonergic processing and oestrogen response. In women, the prevalence of migraine and mood disorders are more common when compared to men. According to B Lee, Peter line study hypothesis states that oestrogen plays a role in the pathophysiology of migraine and mood disorders. Limbic system and HPA axis are inter linked in human beings and the estrogen modulates and exerts agonistic action on serotonergic system. ABSTRACTBackground: Co morbidity between headache and psychiatric disorders is more prevalent in chronic headache patients. The bipolar disorders and anxiety disorders are predominant in migraine and TTH respectively. This co morbidities have a poor reflection and impact on quality and outcome of chronic headache patients and results in worst prognosis and poor response to medical treatment. Methods: The chronic headache patients especially migraine and tension type of headache were analyzed with following materials such as the structured psychiatric clinical interview with ICD-10 mental and behavioural disorder, DSM-5 criteria. HAM-A, HAM-D, BDI-2, BPRS, young mania rating scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and panic disorder scale. Results: Various subsets of bipolar disorder and anxiety disorder were found as follows: 74% of migraineurs are associated with psychiatric disorders in which bipolar affective disorder 6%, depressive episode 48%, dysthymia 30%, GAD 10% and Panic disorder 6%. 52% of TTH are associated with psychiatric disorders as follows: major depressive episode 52%, GAD 30%, separation anxiety disorder 6%, PTSD 7%, OCD 3% and panic disorder 2%. Conclusions: From previous and future studies the headache can be identified according to subsets of headache with psychiatric disorders make easier to provide appropriate pharmacological and psychological treatment which may reduce the chronicity and intractability of headache.