Elser, H., Farkas, D. K., et al. (2025).
JAMA Neurology.
Abstract
Importance Although past research suggests an association between migraine and attempted suicide, there is limited research regarding risk of attempted and completed suicide across headache disorders.
Objective To examine the risk of attempted and completed suicide associated with diagnosis of migraine, tension-type headache, posttraumatic headache, and trigeminal autonomic cephalalgia (TAC).
Design, Setting, and Participants This was a population-based cohort study of Danish citizens from 1995 to 2020. The setting was in Denmark, with a population of 5.6 million people. Persons 15 years and older who were diagnosed with headache were matched by sex and birth year to persons without headache diagnosis with a ratio of 5:1. Data analysis was conducted from May 2023 to May 2024.
Conclusions and Relevance 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.
Here are some thoughts:
This study identified a significant association between headache diagnoses and elevated risks of both attempted and completed suicide. The analysis revealed a robust and persistent link, with individuals diagnosed with headaches facing a disproportionately higher likelihood of suicidal behavior compared to the general population. While the study did not specify headache subtypes, the findings underscore the need for heightened mental health screening and intervention in patients with headache disorders. Researchers emphasized integrating suicide risk assessments into routine clinical care for this vulnerable population.
Implications for Practice
The results align with broader calls to address mental health comorbidities in chronic pain conditions. Primary care providers, in particular, are urged to adopt proactive strategies, such as safety planning and risk screening, to mitigate suicide risk in patients with headaches. Psychologists also need to identify headaches as a risk for suicide.