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Association between suicidal risks and medication-overuse headache in chronic migraine: a cross-sectional study
Yen-Feng Wang1,2,3, Chia-Chun Yu1, Ai Seon Kuan2,4,5
1Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
The Journal of Headache and Pain
|May 11, 2021
Summary
Medication-overuse headache (MOH) in chronic migraine patients is linked to higher risks of suicidal ideation and suicide attempts. Clinicians should be aware of this association in headache patient care.
Area of Science:
- Neurology
- Psychiatry
- Public Health
Background:
- Substance dependence behaviors are prevalent in medication-overuse headache (MOH) patients.
- The association between MOH and increased suicide risk, similar to other substance use disorders, remains uninvestigated.
Purpose of the Study:
- To investigate the relationship between medication-overuse headache (MOH) and the risk of suicidal ideation and suicide attempts in chronic migraine (CM) patients.
Main Methods:
- A cross-sectional study involving newly diagnosed chronic migraine (CM) patients with or without coexisting MOH.
- Data collected via face-to-face interviews by headache specialists, including demographics, headache profiles, and validated scales for disability, anxiety, depression, and sleep quality.
- Specific questioning regarding suicidal ideation and prior suicide attempts.
Main Results:
- Out of 603 CM patients, 320 had MOH (53.1%).
- 214 patients (35.5%) reported suicidal ideation, and 81 (13.4%) had a prior suicide attempt.
- MOH presence significantly increased the risk for suicidal ideation (OR=1.75) and prior suicide attempt (OR=1.88) in CM patients, even after adjusting for confounding factors.
Conclusions:
- Medication-overuse headache (MOH) is significantly associated with increased risks of suicidal ideation and prior suicide attempts in chronic migraine (CM) patients.
- This finding highlights the need for clinical attention among healthcare providers managing headache patients.
- Further research is required to establish causality and elucidate the underlying pathophysiology.
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