Strong Link Between Headache Diagnoses and Suicide Risk Highlights Need for Behavioral Health Support: JAMA
Researchers in a new study have found that patients diagnosed with headache disorders are at a significantly higher risk of attempted and completed suicide compared to the general population. A recent cohort study over 25 years showed a strong association between migraine, tension-type headache, posttraumatic headache, trigeminal autonomic cephalalgia (TAC), and increased suicide risk. The study was conducted by Holly E. and colleagues published in the journal JAMA Neurology.
A population-based cohort study examined Danish citizen data from 1995 to 2020: a total of 119,486 individuals with diagnoses of headache. These subjects were matched 5:1 with 597,430 control subjects from the general population on sex and birth year. The purpose of the study was to determine the risks for attempted and completed suicide in patients diagnosed with different headache disorders.
Data for headache diagnoses were drawn from hospital inpatient records, emergency department visits, and outpatient specialty clinics based on International Classification of Diseases, Tenth Revision (ICD-10) codes. The study identified suicide attempts using diagnostic codes from the Danish National Patient Registry and the Danish Psychiatric Central Research Register. Completed suicides were identified from the Danish Register of Causes of Death. Adjustments were made for factors such as age, sex, education, income, and baseline comorbidities.
Key Findings
• The 15-year absolute risk (AR) of attempted suicide among people with headache disorders was 0.78% (95% CI, 0.72%-0.85%), whereas in the general population, it was 0.33% (95% CI, 0.31%-0.35%). The RD was 0.45% (95% CI, 0.39%-0.53%).
• The 15-year AR of completed suicide among patients with headache disorders was 0.21% (95% CI, 0.17%-0.24%), whereas the comparison cohort had an AR of 0.15% (95% CI, 0.13%-0.16%), with an RD of 0.06% (95% CI, 0.02%-0.10%).
• The HR for attempted suicide was 2.04-fold higher in individuals with headache disorders than in those without headache disorders (95% CI, 1.84-2.27), and the HR for completed suicide was 1.40-fold higher in individuals with headache disorders than in those without headache disorders (95% CI, 1.17-1.68).
• The association persisted across headache types, but posttraumatic headache and TAC demonstrate the strongest correlation with increased suicide risk.
The study authors concluded a close link between headache disorders and an elevated risk of attempting and completing suicide. The evidence underscores the great need for a behavioral health evaluation and intervention among patients suffering from these conditions. By integrating mental health care into headache treatment, healthcare providers might reduce suicide risk and improve outcomes for patients.
Reference:
Elser H, Farkas DK, Fuglsang CH, Sørensen ST, Sørensen HT. Risk of Attempted and Completed Suicide in Persons Diagnosed With Headache. JAMA Neurol. Published online February 03, 2025. doi:10.1001/jamaneurol.2024.4974
