A new Danish study has revealed that people diagnosed with headaches face a significantly higher risk of attempted and completed suicide, regardless of the type of headache they experience. The findings suggest that even milder forms of headache may require mental health evaluation and support.
The extensive research, published in JAMA Neurology on February 3, followed 119,486 people diagnosed with headaches and 597,430 matched individuals from the general population over a 25-year period. The study found that people with headache diagnoses were twice as likely to attempt suicide and 40% more likely to complete suicide compared to those without headaches.
Over a 15-year period, 0.78% of people with headaches attempted suicide, compared to 0.33% in the general population. Similarly, 0.21% of headache sufferers completed suicide, versus 0.15% in the comparison group.
“The robust and persistent association with attempted and completed suicide across headache disorders suggests that patients diagnosed with headache may benefit from concurrent behavioral health evaluation and treatment,” the researchers concluded.
The study tracked various types of headaches, including migraines, tension headaches, and cluster headaches. Surprisingly, even tension-type headaches – known for their mild to moderate intensity – showed strong associations with suicide risk, challenging previous assumptions that only severe headaches posed significant mental health concerns.
The research team, led by Dr. Holly Elser from the Hospital of the University of Pennsylvania, analyzed data from Danish national health registries between 1995 and 2020. The comprehensive dataset included information from hospital admissions, emergency department visits, and outpatient specialty clinic visits.
The findings were particularly striking for certain headache types. People with post-traumatic headaches and trigeminal autonomic cephalalgias (TACs) showed the highest risk levels. The relationship between headaches and suicide risk remained consistent across different age groups, education levels, and income brackets.
Notably, the study found that patients first diagnosed with headaches in emergency departments or as hospital inpatients showed higher suicide risks than those diagnosed in outpatient settings, possibly indicating that headache severity plays a crucial role in mental health outcomes.
The research has significant implications for healthcare providers. The findings suggest that mental health screening should become a standard part of headache treatment, regardless of headache type or severity. Tools such as the Patient Health Questionnaire 9 and the Columbia Suicide Severity Rating Scale could help identify at-risk patients.
The study’s scope is particularly significant given that headaches are among the most common disorders worldwide, with a global lifetime prevalence of 66.6%. Among working-age adults, headache disorders are leading causes of productivity losses, work absences, and short-term disability.
While the exact mechanisms linking headaches to suicide risk remain unclear, researchers suggest several possibilities. These include a complex relationship between headaches and psychiatric conditions, the impact of chronic pain, and potential biological factors involving serotonin and inflammatory responses.