Background and aims
Chronic tension-type headache(CTTH) is the most prevalent headache disorder in the general population,ranging from 20% to 60%.We analyzed psychological symptoms' distribution,gender-age structure,marital status,pain severity,education level and pain impact on work,social,family obligations in CTTH patients. 
Methods
We conducted a cross-sectional study of 170 CTTH patients,who attended pain clinic in Sept. 2017–Nov. 2018.The diagnose met International Classification of Headache Disorders criteria.The analyzing parameters were obtained at admission and included routine examination performed by neurologist(as well as pain intensity by Visual analogue Scale),psychological assessment performed by psychiatrist. Hospital Anxiety and Depression Scale(HADS) was used to evaluate anxiety and depression, considering depression or anxiety if the score was≥10.
Results 
61% of the patients were females.The patients’ mean age was 39.8±9.7.Most patients were in their working age (21-30–11%; 31-40–18.3%; 41-50–24.5%; 51-60–22.6%),but there were patients under 20–2.1% and 61-70–13.4%,over 70–8.1%.The majority of them got a higher education(60.9%) and was married(54.3%).Pain affected productive functioning in the family in 29,3% patients,at work–37.6% and in society–33.1%.All the patients had anxiety:the mean HADS index was 15.8±1.3points in the anxiety subscale.Depression was diagnosed in 44.2%(mean HADS index in the depression subscale score 13.1±1.8).The mean pain intensity was 6.9±0.9 VAS points.Based on chi-square test statistic for independence p < 0,001 it was founded that pain severity virtually depends on gender,age,education level,marital and employment status and the diagnoses.
Conclusions
Psychological aspects in CTTH patients included depression and anxiety that in turn influence pain severity.Moreover,one in three patients admit a negative CTTH impact on work,social,family obligations.

PSYCHOLOGICAL AND DEMOGRAPHICAL ASPECTS OF CHRONIC TENSION-TYPE HEADACHES: PATIENTS' ATTENDANCE IN THE PAIN CLINIC