Craniocervical Pain, Sleep Quality, Depressive Symptoms, and Physical Activity in Healthcare Workers During COVID-19 Pandemic.

BACKGROUND: An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. AIMS: To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: Healthcare workers. SETTINGS: An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). METHODS: The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance. RESULTS: Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). CONCLUSION: Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.

Psychiatric symptoms are frequent in idiopathic intracranial hypertension patients.

Idiopathic intracranial hypertension (IIH) is a rare disease with an incidence rate of 0.5-2.0/100,000/year. Characteristic symptoms are headache and several degrees of visual impairment. Psychiatric symptoms in association with IIH are usually poorly described and underestimated. In this study, we evaluated IIH subjects to determine the association with psychiatric symptoms. We evaluated thirty consecutive patients with IIH submitted to neurosurgery from January 2017 to January 2020 in two Brazilian tertiary hospitals. They underwent clinical evaluation, obtaining medical history, comorbidities, body mass index (BMI-kg/m2), and applying Neuropsychiatric Inventory Questionnaire (NPI-Q). There were 28 females and 2 males. Ages ranged from 18 to 66 years old, with mean age of 37.97 ± 12.78. Twenty-five (83%) presented comorbidities, being obese and having arterial hypertension the most frequent. Body mass index ranged from 25 to 35 kg/m2 and mean value was 31 ± 3.42. After application of Neuropsychiatric Interview, 26 of 30 presented psychiatric symptoms (86%). Depression-anxiety syndromes were reported in 25 patients (83%). Nighttime disturbances were reported by 14 subjects (46%). Appetite and eating disorders were described by 23 (76%). Psychiatric symptoms in association with IIH are usually poorly described and underestimated. In our sample, twenty-six out of 30 (86%) reported psychiatric symptoms. We highlight the high prevalence of psychiatric symptoms among IIH patients and the need of managing these patients with a multidisciplinary team, including psychiatrists.

Head injury and neuropsychiatric sequelae in asylum seekers.

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.

Chronic migraine headache and multiple dental pathologies causing cranial pain for 35 years: the neurodental nexus.

We report a case that illustrates how chronic migraine headaches and multiple dental pathologies caused severe and long-standing cranial pain that affected the quality of life of a man for more than 35 years. His case was investigated at several settings including the neurology outpatient clinic of the hospital without a definitive diagnosis or resolution. After investigations, multiple oral pathologies including two occult dental abscesses were diagnosed. Once both affected teeth and associated abscesses were surgically removed, with subsequent antibiotic therapy the headaches resolved.

Prevalence of headache and orofacial pain in adults and elders in a Brazilian community: an epidemiological study.

BACKGROUND AND OBJECTIVE: Headache and orofacial pain are often persistent and not easy to be evaluated. The objective of this study was to investigate the epidemiology of headache and orofacial pain in Brazilian adults and elders in a district of São Paulo (Brazil). STUDY DESIGN: population-based cross-sectional; Adults (18-59 years old) and elderly people (above 60 years old) were evaluated according to their socio-demographic characteristics, prevalence and location of pain and associated factors. The subjects were interviewed about their orofacial complaints, which were investigated with a validated questionnaire. RESULTS: Five hundred and five adults and 385 elders agreed in participating of this study. More than half of the population had pain (45.3% of adults and 56.6% of elderly); 10.6% of subjects had bruxism and 10.2% had toothache; 48.6% of the adults with pain and 58.7% of the elders with pain had impairment in daily activities due to the pain. The prevalence of head and facial pain was 55.5%. Headache was more prevalent in the adult group compared with the elderly group. Bruxism was associated with headache (p = 0.029), toothache (p < 0.001), facial pain (p < 0.001) and fatigue at the face (p = 0.004). CONCLUSION: This study showed a high prevalence of head and orofacial pain, and their potential aetiologies need further investigation. The pain complaints were associated with comorbidities and the use of medication. Facial painful diseases impact the quality of life of adults and should be diagnosed and treated.

Religiousness and headache: is there a relation? Results from a representative sample of adults living in a low-income community.

BACKGROUND: The use of religious behaviors to alleviate the consequences of stressful life circumstances is a frequent strategy employed by pain sufferers. Specifically in the field of headache research, to date, few studies have assessed spiritual and religious beliefs. OBJECTIVE: The objective of this article is to investigate the relation between religiousness (organizational, non-organizational and intrinsic) and headache disorders in a representative sample of adults living in a low-income community. METHODS: This was a cross-sectional, population-based study. In 2005, we conducted door-to-door interviews with 439 people, aged more than 18 years, randomly selected from a low-income community in Brazil. Four regression models were created to explain the relationships between religious involvement and headache, controlling for demographics, depression/anxiety and alcohol use and smoking. RESULTS: Of the 439 households contacted, at least one member from 383 (87.2%) households participated. We interviewed more women (74.4%) and more subjects aged 18-39 years. The mean age was 41.7 (SD 8.5) years. Bivariate analysis shows that high religious attendance, non-organizational religiousness and intrinsic religiousness were associated with presence of headache and presence of migraine. After the logistic regression models, only high non-organizational religiousness remained associated with presence of headache (odds ratio (OR): 1.22 (1.01-1.49)). All other religious variables were unrelated to the presence of headache and its types. CONCLUSION: There is a modest relationship between high non-organizational religiousness and presence of headache. Headache sufferers may use coping strategies such as private religious behaviors to try to overcome suffering.

Headaches, quality of life, and academic performance in schoolchildren and adolescents.

BACKGROUND: Just a few studies to date have focused on headaches, quality of life, and academic performance in children. OBJECTIVE: Determine the effect of headaches on the life of schoolchildren and the association between headaches and academic performance. METHODS: We conducted a cross-sectional study. One hundred and ninety-five students from an elementary school were randomly selected out of 355 students aged from 10 to 15 years old. Semi-structured interview, the Pediatric Quality of Life Inventory Version 4.0, the Children's Depression Inventory, and the State-Trait Anxiety Inventory were used. The variables relating to academic performance were obtained by consulting the academic records. RESULTS: Prevalence of headaches: headache: 97.3% (179/184); migraine: 51% (94/184); tension-type headache: 33% (61/184); primary stabbing headache: 7.6% (14/184); unclassified headaches: 5.4% (10/184). Migraine (relative risk: 3.11; 95% confidence interval: 1.54-6.30) and more severe headaches (relative risk: 7.93; 95% confidence interval: 2.65-23.7) were associated with lower quality of life (P < .01; multivariate logistic regression). More severe headaches were associated with lower grades in school (P < .01; multiple linear regression). Variables relating to headaches were not associated with "failing the school year" (P > .05; chi-square test and Fisher's exact test). CONCLUSION: Headaches were found to be associated with lower quality of life and poor academic performance.

Psychological adjustment in children with episodic migraine: a population-based study

We investigated psychological adjustment in a preadolescent pediatric population as a function of headache diagnosis. Children from a city public education system were enrolled in this study. (AU)

Psychological adjustment in children with episodic migraine: a population-based study

We investigated psychological adjustment in a preadolescent pediatric population as a function of headache diagnosis. Children from a city public education system were enrolled in this study.

Association between primary headaches and depression in young adults in southern Brazil / Estudo da relação entre enxaqueca primária e depressão em jovens da região sul do Brasil

OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI) and Migraine Disability Assessment (MIDAS) were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI > 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headacherelated disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.

OBJETIVO: Verificar a associação entre depressão e cefaleia em adultos jovens, assim como identificar as características da cefaleia relacionadas com depressão e a influência da depressão na incapacidade decorrente da cefaleia. MÉTODOS: Estudo transversal com questionários autoadministrados sobre cefaleia e depressão foi conduzido na Universidade de Caxias do Sul. O Inventário de Depressão de Beck (BDI) e o questionário de avaliação da incapacidade por enxaqueca (MIDAS) foram utilizados para avaliação dos sintomas depressivos e incapacidade, respectivamente. Depressão foi definida como BDI > 15. RESULTADOS: Foram incluídos no estudo 1.013 adultos jovens. Observou-se uma clara relação entre cefaleia e depressão entre os participantes. Análisesmultivariadas demonstraramque náuseas ou vômitos relacionados à cefaleia e incapacidade decorrente da dor foram fatores independentes associados à depressão. Enxaqueca foi mais associada com depressão que os outros tipos de cefaleia. CONCLUSÃO: Os resultados demonstram associação entre cefaleia e depressão. Sintomas depressivos são mais comuns em adultos jovens com cefaleias mais incapacitantes.

Association between primary headaches and depression in young adults in southern Brazil.

OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI) and Migraine Disability Assessment (MIDAS) were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI ≥ 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headache-related disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.

Annoyance evaluation and the effect of noise on the health of bus drivers.

In the present study, we evaluated annoyance and the effects of noise on the health of bus drivers. For that, 200 bus drivers from a public transport company participated in a cross-sectional study. Annoyance and effects on health was measured with analog scale: Sleep quality, occurrence of tinnitus, headache, irritation, and annoyance from bus engine, traffic, and passengers. Data of age and working time of bus drivers also were obtained. For noise exposure, LA eq was evaluated in 80 buses. Statistical analysis consisted of mean, standard deviation, minimum, and maximum, Kruskal-Wallis test with post-hoc Dunn, one-way ANOVA with post-hoc Tukey and Spearman's correlation coefficient. Results indicate three groups of bus drivers (not annoyed: (N.A.), a little annoyed (L.A.) and highly annoyed (H.A.)). The group H.A. was younger and with less working time in relation to others, with a significant difference only for age. Regarding sleep quality, there was no significant difference. For results on the occurrence of tinnitus, headache and irritation after work, group H.A. had significantly higher means. Result of annoyance to the bus engine was significantly higher in H.A. than in L.A. and N.A. Annoyance to traffic and passengers, no significant differences were found, but the highest results were found for L.A., followed by H.A. and N.A. Equivalent sound pressure level in buses was above of the limit for occupational comfort. It was concluded that bus drivers has considerable level of noise annoyance and some health effects are perceived. The noise is a factor discomfort ergonomic that may cause effects on health of bus drivers. This study aims to evaluate annoyance and the effects of noise on the health of bus drivers. Cross-sectional study with buses and bus drivers. For that, 200 bus drivers from a public transport company participated in a cross-sectional study. Annoyance and effects on health was measured with analog scale: Sleep quality, occurrence of tinnitus, headache, irritation and annoyance from bus engine, traffic, and passengers. Data of age and working time of bus drivers also were obtained. For noise exposure, LA eq was evaluated in 80 buses. Statistical analysis consisted of mean, standard deviation, minimum and maximum, Kruskal-Wallis test with post-hoc Dunn, one-way ANOVA with post-hoc Tukey and Spearman's correlation coefficient. Results indicate three groups of bus drivers (N.A., a L.A. and H.A.). The group H.A. was younger and with less working time in relation to others, with a significant difference only for age. Regarding sleep quality, there was no significant difference. For results on the occurrence of tinnitus, headache and irritation after work, group H.A. had significantly higher means. Result of annoyance to the bus engine was significantly higher in H.A. than in L.A. and N.A. Annoyance to traffic and passengers, no significant differences were found, but the highest results were found for L.A., followed by H.A. and N.A. Equivalent sound pressure level in buses was above of the limit for occupational comfort. It was concluded that bus drivers has considerable level of noise annoyance and some health effects are perceived.

Generalized anxiety disorder, subthreshold anxiety and anxiety symptoms in primary headache.

AIMS: The aim of the present study was to evaluate the association between generalized anxiety disorder, subthreshold anxiety (SubAnx) and anxiety symptoms in the prevalence of primary headache. METHODS: This cross-sectional study evaluated 383 people from a Brazilian low-income community. One-year prevalence rates of migraine, chronic migraine and tension-type headache were calculated. Anxiety symptoms were then separated into the following groups (based on DSM-IV criteria): no anxiety criteria; one anxiety criterion; two anxiety criteria; and generalized anxiety disorder (GAD). The control group (no headaches) was compared with headache sufferers for each anxiety group using an adjusted model controlled for confounding factors. RESULTS: GAD was present in 37.0% of participants and SubAnx in 16.6%. Those with SubAnx had a 2.28-fold increased chance of having migraine; 3.83-fold increased chance of having chronic migraine, a 5.94-fold increased chance of having tension-type headache and a 3.27-fold increased chance of having overall headache. Some anxiety criteria (irritability, difficulty with sleep, concentration problems, muscle tension and fatigue) had similar prevalence to International Classification of Headache Disorders (ICHD-II) headache criteria such as unilateral pain and nausea for migraine and chronic migraine. CONCLUSION: Headache sufferers seem to have a high prevalence of anxiety symptoms and SubAnx. In addition, the presence of two or more anxiety criteria (not necessarily fulfilling all the criteria for GAD) was associated with having a headache disorder.

Health-related quality of life and depression in patients with dentofacial deformity.

INTRODUCTION: Patients with dentofacial deformities present difficulties at work and in social adaptation. At the same time, they often appear depressed, and as a consequence, the psychosocial aspects of surgery play an important role. The aim of this study was to investigate the effects that depression causes in the quality of life of patients with dentofacial deformity. MATERIAL AND METHODS: Filthy patients were recruited 1 year before undergoing orthognathic surgery and correlated oral and general health with the presence and absence of depression. In order to accomplish this, these patients received an adapted questionnaires of quality of life and Beck Depression Inventory to fill out. Fisher's test was applied, with a significance level of 5 %. Intercooled Stata version 9.0 was used to analyze data. RESULTS: Among the eight domains of quality of life, there were three associated with depression status: vitality (p < 0.001), social aspects (p = 0.011), and mental health (p = 0.008). DISCUSSION: There is growing interest in the impact of dentofacial deformity conditions on patients' quality of life. The scientific literature has discussed the social aspects of these deformities and showed that untreated patients had low self-esteem and suffered social restrictions before making the orthodontic and surgical treatments. This study concluded that the depression interferes significantly in vitality, social aspects of the individual, and mental health and, at the same time, emphasizes that the orthognathic surgery aims to not only restore esthetics and function to the patient but also improve the quality of life.

Migraine and behavior in children: influence of maternal headache frequency.

We took advantage of a large population study in order to measure child behavior, as captured by the Child Behavior Checklist (CBCL) as a function of headache status in the children and their mothers. Of the target sample, consents and analyzable data were obtained from 1,856 families (85.4 %). Headache diagnoses were defined according to the second edition of the International Classification of Headache Disorders, and behavioral and emotional symptoms were assessed by the validated Brazilian version of the CBCL. We calculated the relative risk of abnormalities in the CBCL domains as a function of headache status in the children, after adjusting by a series of main effect models. Children with migraine were more likely to present abnormal scores in several of the CBCL scales, relative to children without migraine, and maternal migraine status contributed little to the model. However, when the mother had daily headaches, both children with and without migraine had similar CBCL scores. In multivariate analyses, migraine status in the children predicted CBCL scores (p < 0.01). Headache status and headache frequency in the mother did not predict CBCL scores in children with migraine but predicted in children without migraine (p < 0.01). The burden of migraine to the family is complex. Children with migraine are more likely to have behavioral and emotional symptoms than children without migraine. Children without migraine may be affected, in turn, by frequent headaches experienced by their mothers.

Prevalence and burden of headaches as assessed by the health family program.

BACKGROUND: Unified health systems often have Family Health Programs (FHPs) as a core component of their preventive and early curative strategies. In Brazil, the FHP is established to proactively identify diseases such as diabetes and hypertension. OBJECTIVE: To use the FHP in order to assess the prevalence of primary headaches, as per the Second Edition of the International Classification of Headache Disorders in a Brazilian city covered by the program, and to document the burden of migraine and tension-type headache (TTH) in this population. METHODS: FHP agents were trained on how to apply questionnaires that screened for the occurrence of headaches in the past year. Screening method had been previously validated. Respondents that screened positively were interviewed by a headache specialist, and all their headache types were classified. Additionally, disability (Migraine Disability Assessment Scale and Headache Impact Test) and health-related quality of life were assessed. RESULTS: The 1-year prevalence of migraine was 18.2% [95% confidence interval = 13.7; 23.5]. TTH occurred in 22.9% [18.0%; 28.6%]. Other primary headaches occurred in 10.8% of the participants. Idiopathic stabbing headache was significantly more common in individuals with migraine relative to those without migraine (44.7% vs 10.3%, P < .001). Contrasting with TTH, migraineurs had a mean of 3.1 headache types vs 1.9 in TTH (P < .001). Secondary headaches occurred in 21.7% of the participants over a 1-year period [16.9%; 27.3%]. Most cases were headaches attributed to infection (mostly respiratory). The impact of migraine was bimodal. Most sufferers had little impact, but a sizable minority was severely impaired. CONCLUSIONS: The FHP can be effectively used to bring individuals with headache to the attention of providers. Future investigations should assess whether this increased attention translates into improved outcomes.

Headaches and academic performance in university students: a cross-sectional study.

OBJECTIVES: To estimate the 1-year prevalence of headache, its repercussion and its association with the academic performance of university students. METHODS: Cross-sectional study. Three hundred eighty students were randomly selected out of the 1718, 90.5% of them were interviewed. A semi-structured interview, the Headache Impact Test (HIT-6) and the Hospital Anxiety and Depression Scale were used. The variables related to academic performance: absenteeism, performance coefficient and number of failures in disciplines, were obtained by consulting the academic records. RESULTS: Three hundred forty-four students were interviewed. The headache prevalence was 87.2%. Migraine prevalence was 48.5%. Tension-type headache prevalence was 42.4%. During the 3 months prior to the interview, 8.7% sought emergency services, 30.8% missed class, and 30.8% had a reduction in their productive capacity because of headache. HIT-6: substantial/severe impact = 49%. Multiple linear regressions have shown that serious/very serious-impact headaches are significantly related to greater number of discipline failure and absenteeism. There was no association between student grades and headaches. CONCLUSION: A high prevalence of headache in the studied population was verified. A high headache impact on a student's life was associated with worse academic performance.

Which patients with headache do not seek medical attention?

OBJECTIVES: To evaluate why patients do not discuss their headaches with their doctors and to compare these patients with those who seek medical assistance for headache. METHOD: Cross-sectional study. A total of 200 consecutive patients attended by family doctors had their complaints registered. Those with headaches were interviewed. A semi-structured questionnaire, Headache Impact Test and Hospital Anxiety and Depression Scale were used. RESULTS: Fifty-two percent had headaches. Ten percent sought medical assistance for headache, 11% already had received some form of medical assistance for headache. There was no association between headache disability and seeking a doctor for headache. Patients that did not seek a doctor for headache had a higher prevalence of tension-type headache (59.6% vs. 22.1%; P < .01), a lower prevalence of migraine with aura (32.3% vs. 40.5%; P < .01), headache intensity (5.4 vs. 6.8; P = .01) and frequency (4.2 × 7.4 days/month; P < .01). Fifty-two percent of them needed preventive treatment. Most of them did not seek a doctor because their headaches were mild or received relief from painkillers. CONCLUSIONS: Patients who did not seek medical assistance for headache had more tension-type headache, less migraine with aura, lower headache intensity and frequency, but the same headache disability. Most of them needed preventive treatment and did not seek doctors because their headache was mild or received relief from painkillers.

Associação de cefaleia e ansiedade em estudantes de Medicina de uma universidade do sul de Santa Catarina / Headache and anxiety association among medicine students in an university in South Brazil

Introdução: As cefaleias representam importante problema de saúde pública no Brasil e no mundo devido ao impacto individual e social que essa condição clínica acarreta. Dentre os fatores de ordem psíquica que interferem no processo de dor está a ansiedade, presente em muitas enfermidades físicas e considerada como uma das dificuldades principais enfrentadas pelos seres humanos. O objetivo deste estudo foi estudar a associação entre cefaleia e ansiedade, bem como suas prevalências entre os acadêmicos do curso de Medicina no período de fevereiro a abril de 2009. Métodos: Realizou-se um estudo epidemiológico observacional, com delineamento transversal, através da aplicação de questionários previamente estabelecidos e adaptados, com uma amostra composta por 377 acadêmicos de 1.o ao 12.o semestres, de ambos os sexos, da Universidade do Sul de Santa Catarina, do câmpus de Tubarão. Resultados: Os acadêmicos classificados como ansiosos apresentaram uma prevalência maior de cefaleia quando comparados aos não ansiosos. Dos 377 acadêmicos que participaram do estudo, 69% admitiram apresentar cefaleia e 33% foram classificados como ansiosos. Na análise de regressão múltipla os fatores associados de forma independente à cefaleia foram ansiedade em nível moderado (ORaj=3,17) e sexo feminino (ORaj=3,32). Conclusões: O presente estudo encontrou relação estatisticamente significativa entre cefaleia e ansiedade entre estudantes de Medicina da Unisul/SC/Tubarão. Os acadêmicos ansiosos apresentaram prevalência de cefaleia elevada quando comparados aos não ansiosos

Introduction: Headaches are an important public health problem in Brazil and worldwide due to the individual and social impact entailed by this clinical condition. One of the psychological factors that affect the pain process is anxiety, present in many physical ailments and considered as one of the main difficulties faced by humans. The aim of this study was to examine the association between headache and anxiety, as well as their prevalence among students of medicine in the period from February to April 2009. Methods: An observational, epidemiological cross-sectional study using previously set and adapted questionnaires, of a sample of 377 students of both sexes from the 1st to the 12th semesters at the University of Southern Santa Catarina, Campus de Tubarão. Results: There was a higher prevalence of headache among the students rated as anxious than among non-anxious ones. Of the 377 students who participated in the study, 69% reported having headaches and 33% were classified as anxious. In multiple regression analysis, the factors independently associated with headache were moderate anxiety level (ORaj=3,17) and being a female (ORaj = 3.32). Conclusions: This study found a statistically significant relationship between headache and anxiety among medical students of Unisul/SC/Tubarão. Anxious students showed a high prevalence of headache as compared to non-anxious ones