Association between lifetime headache and history of suicide attempts in the elderly.
Pain-related conditions have been reported to play a key role among risk factors for suicide. Headache in particular has been repeatedly associated with suicidal thoughts and behaviors. The aims of this study were: 1) to assess the association between lifetime headache (both non-migrainous headache and migraine) and lifetime suicide attempts (SA); 2) to differentiate, within subjects with lifetime SA, patients with and without lifetime headache in terms of socio-demographic and clinical features.



We studied 1965 subjects from a cohort of community-dwelling persons aged 65 years and over without dementia (the ESPRIT study), divided in two groups: those with (n=75), and those without a lifetime SA (n=1890). Logistic regression analyses were used to compare these groups according to lifetime headache status.



After adjusting for gender, living alone, tobacco and alcohol consumption, and depressive, manic/hypomanic and anxiety disorders, lifetime headache frequency was significantly higher in subjects with a lifetime SA compared with controls (OR=1.92 [1.17-3.15]). Additionally, different factors were identified as being associated with lifetime SA in participants with lifetime headache (female gender, a lower level of high-density lipoprotein cholesterol, insomnia, lifetime major depression) versus participants without headache (glycemia and lifetime major depression).



Lifetime headache was associated with lifetime SA. Subjects who are women and report the co-occurrence of headache and insomnia as well as lifetime major depression require higher attention and a careful screening for suicidal thoughts and behaviors.
Inserm U1061 - Hôpital La Colombière, Pavillon 42, 39, avenue Charles-Flahault, B.P. 34493, 34093 Montpellier Cedex 5, France; University of Montpellier, 34000 Montpellier, France; FondaMental Foundation, Créteil, France; Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Hôpital Lapeyronie, 371, avenue Gaston-Giraud, 34295 Montpellier, France. Electronic address: raffaella.calati@gmail.com.
R
R
Calati
Inserm U1061 - Hôpital La Colombière, Pavillon 42, 39, avenue Charles-Flahault, B.P. 34493, 34093 Montpellier Cedex 5, France; University of Montpellier, 34000 Montpellier, France; FondaMental Foundation, Créteil, France; Department of Emergency Psychiatry and Post Acute Care, CHU Montpellier, Hôpital Lapeyronie, 371, avenue Gaston-Giraud, 34295 Montpellier, France.
P
P
Courtet
Inserm U1061 - Hôpital La Colombière, Pavillon 42, 39, avenue Charles-Flahault, B.P. 34493, 34093 Montpellier Cedex 5, France; University of Montpellier, 34000 Montpellier, France.
J
J
Norton
Inserm U1061 - Hôpital La Colombière, Pavillon 42, 39, avenue Charles-Flahault, B.P. 34493, 34093 Montpellier Cedex 5, France; Centre for Clinical Brain Sciences, University of Edinburgh, 49, Little France Crescent, EH16 4SB Edinburgh, Scotland.
K
K
Ritchie
Inserm U1061 - Hôpital La Colombière, Pavillon 42, 39, avenue Charles-Flahault, B.P. 34493, 34093 Montpellier Cedex 5, France; University of Montpellier, 34000 Montpellier, France.
S
S
Artero
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*
Community Mental health; Elderly; Headache; Suicide