Risk of suicide high among people with headache disorders

Headache disorders appear to be associated with an elevated risk of suicide, as reported in a population-based cohort study from Denmark.

The study included 119,486 individuals at least 15 years of age who had a headache diagnosis and 597,430 individuals without the condition. These groups were matched according to sex and birth year. The median age of the participants overall was 40.1 years, and 69.5 percent were female.

Researchers used the Danish National Patient Registry, the Danish Psychiatric Central Research Register, and the Danish Register of Causes of Death to obtain data on attempted and completed suicides. They used the cumulative incidence function and Fine-Gray proportional hazards regression for the analyses.

The 15-year absolute risk of attempted suicide was higher in the headache cohort at 0.78 percent (95 percent confidence interval [CI], 0.72–0.85) than in the comparison cohort at 0.33 percent (95 percent CI, 0.31–0.35), corresponding to a risk difference of 0.45 percent (95 percent CI, 0.39–0.53).

Likewise, the 15-year absolute risk of completed suicide was higher in the headache vs the comparison cohort (0.21, 95 percent CI, 0.17–0.24 vs 0.15 percent, 95 percent CI, 0.13–0.16), with a risk difference of 0.06 percent (95 percent CI, 0.02–0.10).

Headache was associated with a twofold increased risk of attempted suicide (HR, 2.04, 95 percent CI, 1.84–2.27) and a 1.4-fold higher risk of completed suicide (HR, 1.40, 95 percent CI, 1.17–1.68).

Results were similar across headache types, with stronger associations for trigeminal autonomic cephalalgia and post-traumatic headache.

The findings highlight the importance of behavioural health evaluation and treatment for patients with headache.