Background: Tension-type headache is a commonly encountered disturbance of neurology and psychiatry and it has been shown to be associated with psychological factors or disturbance such as depression and anxiety. Of particular importance to clinicians are the relationship between anger and alexithymia. In this study, we investigated anger and alexithymia in Korean patients with tension-type headache.

Methods: The subject were 30 patients with tension-type headache diagnosed by neurologist and psychiatrist, and they were compared to 30 healthy control group. The results of medical investigation of patients including brain CT and EEG were negative. All subjects were evaluated for depression, anxiety, anger and anger expression and alexithymia. The measures included Beck Depression Inventory (BDI), Spielberger State-Trait Anxiety Inventory (STAI), Spielberger State-Trait Anger Expression Scale (STAXI), and Toronto Alexithymia Scale (TAS).

Results: The patient with tension-type headache reported significantly more symptoms of depression, more difficulty describing feeling to other in TAS, less anger-in and anger-out expression in STAXI than the control subjects. Depressive symptoms in patients with tension headache were positively correlated with state anxiety, trait anxiety, alexithymia, state anger and anger-in expression.

Conclusion: These finding lend support that tension-type headache is associated with affect dysregulation and it may play role in features of tension headache. Psychosomatic assessment and treatment of patients with tension-type headache will be needed.