Migraine Headaches and Suicide Attempt

Authors

  • Naomi Breslau PhD,

    Corresponding author
    1. From the Department of Epidemiology, Michigan State University College of Human Medicine, East Lansing, MI (N. Breslau); Department of Public Health Sciences, Henry Ford Health System, Detroit, MI (L. Schultz and E. Peterson); Montefiore Headache Center and Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY (R. Lipton); Department of Neurology, The Chicago Medical School, and Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA (K.M.A. Welch).
    Search for more papers by this author
  • Lonni Schultz PhD,

    1. From the Department of Epidemiology, Michigan State University College of Human Medicine, East Lansing, MI (N. Breslau); Department of Public Health Sciences, Henry Ford Health System, Detroit, MI (L. Schultz and E. Peterson); Montefiore Headache Center and Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY (R. Lipton); Department of Neurology, The Chicago Medical School, and Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA (K.M.A. Welch).
    Search for more papers by this author
  • Richard Lipton MD,

    1. From the Department of Epidemiology, Michigan State University College of Human Medicine, East Lansing, MI (N. Breslau); Department of Public Health Sciences, Henry Ford Health System, Detroit, MI (L. Schultz and E. Peterson); Montefiore Headache Center and Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY (R. Lipton); Department of Neurology, The Chicago Medical School, and Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA (K.M.A. Welch).
    Search for more papers by this author
  • Edward Peterson PhD,

    1. From the Department of Epidemiology, Michigan State University College of Human Medicine, East Lansing, MI (N. Breslau); Department of Public Health Sciences, Henry Ford Health System, Detroit, MI (L. Schultz and E. Peterson); Montefiore Headache Center and Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY (R. Lipton); Department of Neurology, The Chicago Medical School, and Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA (K.M.A. Welch).
    Search for more papers by this author
  • K.M.A. Welch MB, ChB, FRCP

    1. From the Department of Epidemiology, Michigan State University College of Human Medicine, East Lansing, MI (N. Breslau); Department of Public Health Sciences, Henry Ford Health System, Detroit, MI (L. Schultz and E. Peterson); Montefiore Headache Center and Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY (R. Lipton); Department of Neurology, The Chicago Medical School, and Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA (K.M.A. Welch).
    Search for more papers by this author

  • Funding: Supported by NIH Headache Research Center (Bethesda, MD) grant P50 NS 32399.

  • Conflict of Interest:

  • Dr. Breslau reports no disclosures.

  • Dr. Schultz reports no disclosures.

  • Dr. Lipton holds stock options in Neuralieve Inc. (a company without commercial products); serves as consultant, advisory board member, or has received honoraria from: Allergan, American Headache Society, Autonomic Technologies, Boston Scientific, Bristol- Myers Squibb, Cognimed, Diamond Headache Clinic, Eli Lilly, Endo, GlaxoSmithKline, Merck, Nautilus Neuroscience, Neuralieve, Novartis, and Pfizer.

  • Dr. Peterson reports no disclosures.

  • [Correction added after online publication 9-March-2012: Update to article acceptance date]

N. Breslau, Department of Epidemiology, Michigan State University, College of Human Medicine, B645 West Fee Hall, East Lansing, MI 48824, USA, email: breslau@epi.msu.edu

Abstract

(Headache 2012;52:723-731)

Background.— Previous cross-sectional studies reported an increased risk of suicide attempt in persons with migraine headache, which was sustained when psychiatric comorbidity was statistically controlled.

Objective.— To estimate the risk of suicide attempt in persons with migraine vs controls with no history of severe headache, using prospective data and validated diagnostic assessment. To examine the specificity of the migraine-suicide attempt risk by comparing it to the risk associated with non-migraine headache of comparable severity and disability.

Methods.— A cohort of persons with migraine (n = 496), non-migraine severe headaches (n = 151), and controls with no history of severe headache (n = 539) was randomly selected from the general community, assessed in 1997 and reassessed 2 years later.

Results.— Persons with migraine had an increased risk of suicide attempt during the 2-year follow-up period, compared with controls. Odds ratio, adjusted for sex, psychiatric disorder, and previous history of suicide attempt at baseline was 4.43 (95% confidence interval [CI] 1.93, 10.2). Persons with non-migraine headache of comparable intensity and disability also had an increased risk of suicide attempt, compared to controls: odds ratio, adjusted for the same covariates, was 6.20 (95% CI 2.40, 16.0). The difference between the 2 estimates was not significant. In the entire sample, headache severity at baseline predicted suicide attempt: a difference of 1 standard deviation (SD) in pain score increased the risk of suicide attempt by 79%, adjusting for sex and psychiatric disorders.

Conclusions.— The results suggest the possibility that pain severity might account in part for the increased risk of suicide attempt associated with migraine.

Ancillary