To investigate the relationship between mental health symptoms and the migraine-tension-type headache (TTH) spectrum in middle-aged adults from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil study). In this cross-sectional analysis (baseline data: 2008–2010), it was evaluated the relationship between each mental health symptom assessed by the Clinical Interview Schedule-Revised (CIS-R) questionnaire and headache subtypes (migraine and TTH) according to international criteria. It was performed binary logistic regression models, with estimated odds ratios (OR) with their respective 95% confidence intervals (CI) adjusted for confounders including migraine attack frequency. Among 13,916 participants, 70.1% reported any major primary headache subtype within the last year. The most common subtype was definite TTH (33.4%), followed by probable migraine (21.0%), definite migraine (8.5%), and probable TTH (7.2%). Our main findings indicated positive associations between anxiety-related symptoms and the migraine-tension type headache (TTH) spectrum with a clear trend toward definite migraine more than tension-type headache. The presence of somatic symptoms presented a high likelihood for the associations with headaches, mainly definite migraine (OR: 7.9, 95% CI: 6.4–9.8), probable migraine (OR: 4.5, 95% CI 3.7–5.4) and probable TTH (OR: 3.0, 95% CI: 2.3–3.8). Other symptoms associated with headache disorders included fatigue, panic, irritability, anxiety symptoms, concentration problems, forgetfulness, depressive symptoms, and worry. The effect of associations remained significant after controlling for headache attack frequency. This study provides evidence of consistent associations between mental health symptoms and primary headache disorders, with a higher burden of anxiety-based symptoms observed in people with migraine than those with TTH.

中文翻译：

---

巴西成人健康纵向研究中心理健康症状与偏头痛-紧张型头痛谱的关联

根据巴西成人健康纵向研究（ELSA-巴西研究）调查中年成年人心理健康症状与偏头痛-紧张型头痛 (TTH) 谱之间的关系。在这项横断面分析（基线数据：2008-2010）中，根据国际标准，评估了临床访谈计划修订版（CIS-R）问卷评估的每种心理健康症状与头痛亚型（偏头痛和 TTH）之间的关系。标准。采用二元逻辑回归模型，估计比值比 (OR) 及其各自的 95% 置信区间 (CI)，针对包括偏头痛发作频率在内的混杂因素进行调整。在 13,916 名参与者中，70.1% 的人在去年报告过任何主要的原发性头痛亚型。最常见的亚型是明确的 TTH (33.4%)，其次是可能的偏头痛 (21.0%)、明确的偏头痛 (8.5%) 和可能的 TTH (7.2%)。我们的主要研究结果表明，焦虑相关症状与偏头痛紧张型头痛 (TTH) 谱系之间存在正相关关系，且明确偏头痛的趋势明显多于紧张型头痛。躯体症状的存在很可能与头痛相关，主要是明确的偏头痛（OR：7.9，95％CI：6.4-9.8），可能的偏头痛（OR：4.5，95％CI：3.7-5.4）和可能的 TTH（ OR：3.0，95% CI：2.3–3.8）。与头痛相关的其他症状包括疲劳、恐慌、烦躁、焦虑症状、注意力不集中、健忘、抑郁症状和担忧。在控制头痛发作频率后，关联的影响仍然显着。这项研究提供了心理健康症状与原发性头痛之间存在一致关联的证据，偏头痛患者的焦虑症状负担高于 TTH 患者。