Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study

Abstract

Objective: To investigate the risk and risk factors for suicide attempt by patients with regular migraines (RM) and status migrainosus (SM) in Taiwan.

Methods: We analyzed a subset of the National Health Insurance Research Database of Taiwan and enrolled patients (≥20 years old) who had ever received a diagnosis of RM or SM between 2000 and 2012 in the RM and SM cohort. The SM cohort included 13,605 patients, the RM cohort had 21,485 patients, and the comparison cohort contained approximately four times that many patients. We calculated the adjusted hazard ratios and 95% confidence intervals (CI) for suicide attempts after adjusting for age, sex, monthly income, urbanization level, occupation, and comorbidities.

Results: The SM cohort had a 1.81-fold risk of attempting suicide (95% CI = 1.14⁻2.89) compared to the comparison cohort. Other factors that predispose patients with SM to attempt suicide include the following: female sex, relatively young age (<50 years old), and low monthly income (<15,000 New Taiwan Dollars, approximately equivalent to 495 US Dollars). Additionally, the risk of attempting suicide only increased in patients who had been diagnosed with SM for longer than five years.

Conclusion: SM is associated with a higher risk for suicide attempt in migraineurs in Taiwan. This finding is important to clinicians and government officials seeking to prevent patients from attempting suicide in Taiwan and other similar East Asian countries.

Keywords: National Health Insurance; cohort study; migraine; suicide.

Figure 1

Cumulative incidences of suicide attempts for patients with status migrainosus and the comparison cohort (A), and for patients with regular migraines and the comparison cohort (B).