Association Between Headache Diagnosis and Suicide Incidence in Danish Population Study

In a new article published in JAMA Neurology, researchers detail their investigation into whether there is an increased risk for attempted and completed suicide associated with a diagnosis of headache.

The population-based cohort study of Danish citizens from 1995 to 2020 included individuals diagnosed with migraine, tension-type headache, posttraumatic headache, and trigeminal autonomic cephalalgia. Individuals aged 25 years or older who were diagnosed with headache were matched by birth year and sex to individuals without a diagnosis of headache.

Diagnostic codes from the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision were used to identify attempted suicide from the Danish National Patient Registry and the Danish Psychiatric Central Research Register databases and completed suicides from the Danish Register of Causes of Death.

The researchers calculated absolute risks (ARs) and risk differences (RDs) using the cumulative incidence function; hazard ratios (HRs) were adjusted for age, sex, year of birth, income, baseline comorbidities, and accounting for competing risk for death.

A total of 119,486 individuals diagnosed with headache were included and were matched 5:1 to control individuals without a headache diagnosis. The 15-year AR of attempted suicide among individuals with headache was 0.78% (95% CI, 0.72%-0.85%) versus 0.33% (95% CI, 0.31%-0.35%) among those in the control cohort (RD, 0.45%; 95% CI, 0.39%-0.53%).

The 15-year AR for completed suicide among individuals with headache was 0.21% (95% CI, 0.17%-0.24%) versus 0.15% (95% CI, 0.13%-0.16%) in the control cohort (RD, 0.06%; 95% CI, 0.02%-0.10%).

The risks for attempted suicide (HR, 2.04; 95% CI, 1.84-2.27) and completed suicide (HR, 1.40; 95% CI, 1.17-1.68) were elevated among individuals with headache versus those without headache. Findings were consistent across headache types, with stronger associations for trigeminal autonomic cephalalgia and posttraumatic headache.

“Results of this cohort study revealing the robust and persistent association of headache diagnoses with attempted and completed suicide suggest that behavioral health evaluation and treatment may be important for these patients,” the researchers concluded.

Source

JAMA Neurology