Psychological issues in the evaluation and treatment of tension-type headache

Tension-type headache (TTH) is a common disease that is usually minimally impairing. However, more chronic TTH can be associated with significant disability and psychological comorbidity. Psychological assessment can help elucidate the biopsychosocial issues that complicate TTH and reveal the patient's coping styles. Psychological therapies, such as relaxation training, cognitive behavioral therapy, and biofeedback, may be helpful in reducing the frequency of TTHs and decrease the associated disability. Special populations, including pediatric patients, pregnant patients, and geriatric patients, may especially benefit from psychological interventions. Further work needs to be done in researching the effects of psychological treatments and making them available to a wider population.