Suicide in primary headaches in 48 countries: A physician-survey based study

Area of Science:

• Neurology
• Psychiatry
• Public Health

Background:

• Primary headache disorders are prevalent worldwide.
• The association between primary headaches and suicidal ideation or behavior is not fully understood.
• Existing research indicates a potential link, necessitating further investigation.

Purpose of the Study:

• To explore the global relationship between primary headache types and suicide (both accomplished and attempted).
• To quantify the risk of suicide associated with specific primary headache disorders.
• To assess healthcare professionals' perspectives on managing headache-related suicide risk.

Main Methods:

• A global survey involving 203 headache specialists from 48 countries.
• Data collection through face-to-face interviews using a questionnaire focused on suicide due to headaches.
• Cross-continental data analysis to identify regional variations and commonalities.

Main Results:

• Primary headaches contribute to approximately 1 suicide per million population annually.
• Cluster headache and migraine account for the majority (70-80%) of headache-related suicides.
• Suicide attempts are 10 times more common than completed suicides, with cluster headache posing a higher risk than migraine, especially in patients with a psychiatric history.

Conclusions:

• Cluster headache and migraine are significant risk factors for suicide and should not be considered benign conditions.
• A substantial proportion of physicians believe that more aggressive headache management could decrease suicide rates.
• Early recognition and proactive treatment of primary headaches are crucial for suicide prevention.