Behavioural and psychological features are neither unique nor related to headache and neck pain characteristics in patients with tension-type headache.

OBJECTIVE: To evaluate between group and individual data across five behavioural and psychological features (fatigue, poor sleep, perceived stress, anxiety and depression) in individuals with tension-type headache (TTH), idiopathic neck pain (INP) and healthy controls (HC). METHODS: A secondary analysis of a cross-sectional study in 65 individuals with TTH, 17 with INP and 20 HC. Behavioural and psychological measures, headache, neck pain and disability and sensory measures were collected from the relevant groups. RESULTS: The TTH group compared to HC had higher scores and percentages of participants with fatigue, poor sleep and anxiety symptoms (all p < 0.01) but similar levels to the INP group apart from perceived stress where the INP group scored higher (p < 0.01). Clinically relevant scores in at least 2/5 features were seen in 65% and 53% of individuals in the TTH and INP groups respectively, while 70% HC had mostly normal scores. Individuals with TTH and >2/5 clinically relevant scores, had higher headache disability (p = 0.019) but no differences in headache, neck pain and pain sensitivity than those with 0-1/5 feature. CONCLUSIONS: Individuals with TTH are heterogeneous in terms of behavioural and psychological features. More behavioural and psychological features were not necessarily related to headache and neck pain severity, pain sensitivity, or chronicity. Individuals with idiopathic neck pain exhibit similar features to those with TTH suggesting they may align to a pain state rather than specifically to TTH.