The frequency and quality of headaches reported by 300 psychiatric patients were analyzed and compared to findings drawn from a general practice sample. Migraine and tension headaches were commonly reported and were found to be considerably more severe and frequent among psychiatric patients than among those patients attending a general practice. However, few of the psychiatric patients regarded their headaches as a major problem. Those who were headache sufferers had significantly higher scores on a psychometric assessment of neurotic tendency and were more frequently diagnosed as suffering from neurons than were those who reported few or no headaches. There was no association between headache and the diagnosis of depression, but psychometric scores on depression were significantly higher among the headache cases. The scale may have been reflecting general psychiatric distress rather than depression as such. The possibility that headaches contribute significantly to psychiatric distress, and are not merely a symptom of such distress, is considered.