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

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 798-803 ◽  
Author(s):  
Jose Maria Trejo-Gabriel-Galan ◽  
Irene Aicua-Rapún ◽  
Esther Cubo-Delgado ◽  
Carmen Velasco-Bernal
Keyword(s):  
Cluster Headache ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Primary Headache ◽  
Primary Headaches ◽  
Psychiatric History ◽  
Physician Survey ◽  
Aggressive Treatment ◽  
Face To Face ◽  
The Relationship

Aim To investigate the relationship between primary headache types and accomplished or attempted suicide in countries from all world regions. Methods Data were obtained using a questionnaire about suicide due to headache in a face-to-face interview with 203 physicians with expertise in headaches. They came from 48 countries, and from all continents. Results Primary headaches cause one suicide per 1,000,000 population each year (1% of the suicide rate due to all causes). Cluster headache and migraines account for 70–80% of them. Suicide attempts are 10 times more frequent than accomplished suicides. Cluster headache poses more risk than migraine. This risk is not often acknowledged, and is increased if there is previous psychiatric history. More than half of the physicians interviewed think it could be reduced with a more aggressive treatment of headaches. Conclusions Cluster headache and migraine are not always benign, and are the cause of the majority of suicides due to headache.

The Risk of Child Abuse among Mothers who Attempt Suicide

1985 ◽  
Vol 146 (5) ◽  
pp. 486-489 ◽  
Author(s):  
Keith Hawton ◽  
Jacqueline Roberts ◽  
Guy Goodwin
Keyword(s):  
At Risk ◽  
Child Abuse ◽  
General Population ◽  
Young Children ◽  
General Hospital ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Population Control ◽  
Not At Risk ◽  
The Relationship

SummaryThe association between parental attempted suicide and child abuse was investigated in 114 mothers with children aged five years and under, referred to a general hospital following suicide attempts. The risk was greatly increased in the attempted suicide mothers, compared with both similar mothers at risk for depression and general population control mothers; well-documented risk of child abuse was identified in 29.8% of those who attempted suicide. No major differences were found between the attempted suicide mothers whose children were at risk and those whose children were not at risk. During the general hospital assessment of mothers with young children who attempt suicide, careful enquiry concerning the relationship with the children is essential

Child Abuse and Attempted Suicide

1980 ◽  
Vol 137 (4) ◽  
pp. 319-323 ◽  
Author(s):  
Jacquie Roberts ◽  
Keith Hawton
Keyword(s):  
Child Abuse ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Previous History ◽  
Psychiatric Disturbance ◽  
At Risk Children ◽  
History Of ◽  
Group A ◽  
Marital Breakdown ◽  
The Relationship

SummaryOf a sample of families containing abused and at risk children, in 29 per cent one or both parents had attempted suicide. The rate at which the suicide attempts were repeated within a year was higher than that expected for other attempters of the same age group. A previous history of psychiatric disturbance and marital breakdown was strongly associated with the combination of child abuse and suicidal behaviour. The relationship between child abuse and attempted suicide did not appear in most cases to have been a direct one; often both forms of behaviour seemed to reflect marital difficulties.

scholarly journals Primary Headache in Yemen: Prevalence and Common Medications Used

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Salah A. Abdo ◽  
Mohammed Amood AL-Kamarany ◽  
Karem H. Alzoubi ◽  
Mohamed T. Al-Maktari ◽  
Abdulrhman H. Al-Baidani
Keyword(s):  
Diclofenac Sodium ◽  
Case Series ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Simple Explanation ◽  
Cross Sectional ◽  
High Prevalence ◽  
Type Headache ◽  
The Relationship

Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen.Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004).Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH) was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH) was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P<0.05), while between primary headache and sex was not (P>0.05). In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL). 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist) regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%). Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45%) were unknown agents.Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.

scholarly journals The Trigeminovascular System in Humans: Pathophysiologic Implications for Primary Headache Syndromes of the Neural Influences on the Cerebral Circulation

1999 ◽  
Vol 19 (2) ◽  
pp. 115-127 ◽  
Author(s):  
Arne May ◽  
Peter J. Goadsby
Keyword(s):  
Positron Emission Tomography ◽  
Cluster Headache ◽  
Primary Headache ◽  
Emission Tomography ◽  
Primary Headaches ◽  
Trigeminovascular System ◽  
Pain Attack ◽  
Trigeminal Pain ◽  
Positron Emission ◽  
Neural Influences

Primary headache syndromes, such as cluster headache and migraine, are widely described as vascular headaches, although considerable clinical evidence suggests that both are primarily driven from the brain. The shared anatomical and physiologic substrate for both of these clinical problems is the neural innervation of the cranial circulation. Functional imaging with positron emission tomography has shed light on the genesis of both syndromes, documenting activation in the midbrain and pons in migraine and in the hypothalamic gray in cluster headache. These areas are involved in the pain process in a permissive or triggering manner rather than as a response to first-division nociceptive pain impulses. In a positron emission tomography study in cluster headache, however, activation in the region of the major basal arteries was observed. This is likely to result from vasodilation of these vessels during the acute pain attack as opposed to the rest state in cluster headache, and represents the first convincing activation of neural vasodilator mechanisms in humans. The observation of vasodilation was also made in an experimental trigeminal pain study, which concluded that the observed dilation of these vessels in trigeminal pain is not inherent to a specific headache syndrome, but rather is a feature of the trigeminal neural innervation of the cranial circulation. Clinical and animal data suggest that the observed vasodilation is, in part, an effect of a trigeminoparasympathetic reflex. The data presented here review these developments in the physiology of the trigeminovascular system, which demand renewed consideration of the neural influences at work in many primary headaches and, thus, further consideration of the physiology of the neural innervation of the cranial circulation. We take the view that the known physiologic and pathophysiologic mechanisms of the systems involved dictate that these disorders should be collectively regarded as neurovascular headaches to emphasize the interaction between nerves and vessels, which is the underlying characteristic of these syndromes. Moreover, the syndromes can be understood only by a detailed study of the cerebrovascular physiologic mechanisms that underpin their expression.

scholarly journals The rs6265 Polymorphism of the BDNF Gene Is Related to Higher-Lethality Suicide Attempts in the Korean Population

2020 ◽  
Vol 17 (5) ◽  
pp. 417-423
Author(s):  
Seung-Gul Kang ◽  
Jong Hun Lee ◽  
Kwanghun Lee ◽  
Hee-Cheol Kim ◽  
Wan Seok Seo ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Relative Risk ◽  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Clinical Symptoms ◽  
Relative Risk Ratio ◽  
Bdnf Gene ◽  
Replication Studies ◽  
The Relationship

Objective Since the risk of suicide cannot be predicted by clinical symptoms alone, and suicide is known to have a genetic component, the discovery of genetic markers that can predict the lethality of suicide attempts is a clinically important topic. There have been many studies aiming to determine whether the rs6265 polymorphism of the BDNF gene is associated with suicidality; however, the results have been mixed, and there have been few studies investigating the relationship between this polymorphism and suicide attempt lethality.Methods We assessed suicide lethality in 258 individuals who had attempted suicide using the relative risk ratio (RRR) scale and by genotyping the rs6265 polymorphism of the BDNF gene.Results The RRR score for suicide attempts was higher in subjects with Met/Val and Val/Val genotypes than in that with a Met/Met genotype (p=0.015). The RRR score for suicide attempts was also higher in Val allele carriers (Met/Val+Val/Val) than in Met/Met homozygotes (p=0.006).Conclusion This study demonstrates the possibility that the rs6265 polymorphism of the BDNF gene could be used as a genetic marker to predict the lethality of suicide attempts, but more replication studies are needed for the application of this result in clinical practice.

Experience of suicidal thoughts: A discourse analytic study.

2014 ◽  
Vol 10 (2) ◽  
pp. 117-127 ◽  
Author(s):  
Dariusz Galasiński ◽  
Justyna Ziółkowska
Keyword(s):  
Suicidal Ideation ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Hospitals ◽  
Homogeneous Group ◽  
Analytic Study ◽  
Service Users ◽  
Suicidal Thoughts ◽  
The Relationship ◽  
Insight Into

In the paper we explore the relationship between current psychiatric thinking on suicide and service users’ accounts of suicidal ideation and suicide attempts. The data comes from recordings of psychiatric interviews collected in three psychiatric hospitals in Poland. Assuming a constructionist view of discourse we argue that the literature on suicide ignores and simplifies the experience of those who think about suicide and attempt to commit it and constructs their experiences as a homogeneous group of ‘thoughts’ only with content (without form). We also offer a preliminary insight into the complexity of ‘suicide thoughts, as narrated by those reporting them. We demonstrate that they are marginalised and made relatively irrelevant in the accounts of attempted suicide. Additionally, we demonstrate that while women construct suicide attempts (whether actually attempted in the end or not) as at least potentially beyond their control, men’s narratives very show them in control of the attempt, as if choosing an available option. We conclude by exploring possibilities of further qualitative discourse analytic research which builds on the findings we present here.

scholarly journals Calcitonin Gene-Related Peptide (CGRP) and Cluster Headache

2020 ◽  
Vol 10 (1) ◽  
pp. 30 ◽  
Author(s):  
Andrea Carmine Belin ◽  
Caroline Ran ◽  
Lars Edvinsson
Keyword(s):  
Cluster Headache ◽  
Pain Perception ◽  
Primary Headache ◽  
Active Phase ◽  
Calcitonin Gene Related Peptide ◽  
Primary Headaches ◽  
Cgrp Receptor ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Autonomic Reflex

Cluster headache (CH) is a severe primary headache with a prevalence of 1/1000 individuals, and a predominance in men. Calcitonin gene-related peptide (CGRP) is a potent vasodilator, originating in trigeminal neurons and has a central role in CH pathophysiology. CGRP and the CGRP receptor complex have recently taken center stage as therapeutic targets for primary headaches, such as migraine. Multiple CGRP and CGRP receptor monoclonal antibodies, as well as small molecule antagonists (gepants) are on their way constituting a new frontier of migraine and possibly CH medication. During a CH attack, there is an activation of the trigeminal-autonomic reflex with the release of CGRP, and inversely if CGRP is administered to a CH patient in an active disease phase, it triggers an attack. Increased levels of CGRP have been found in ipsilateral jugular vein blood during the active phase of CH. This process is hypothesized to have a key role in the intense pain perception and in the associated distinctive vasodilation. So far, clinical tests of CGRP antibodies have been inconclusive in CH patients. This review summarizes the current state of knowledge on the role of CGRP in CH pathology, and as a target for future treatments.

scholarly journals Cluster Headache: Evidence for a Disorder of Circadian Rhythm and Hypothalamic Function

2002 ◽  
Vol 29 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Tamara Pringsheim
Keyword(s):  
Circadian Rhythm ◽  
Cluster Headache ◽  
Suprachiasmatic Nucleus ◽  
Biological Clock ◽  
Primary Headache ◽  
Headache Disorder ◽  
Primary Headache Disorders ◽  
Hypothalamic Function ◽  
The Relationship ◽  
Further Development

This article reviews the literature for evidence of a disorder of circadian rhythm and hypothalamic function in cluster headache. Cluster headache exhibits diurnal and seasonal rhythmicity. While cluster headache has traditionally been thought of as a vascular headache disorder, its periodicity suggests involvement of the suprachiasmatic nucleus of the hypothalamus, the biological clock. Normal circadian function and seasonal changes occurring in the suprachiasmatic nucleus and pineal gland are correlated to the clinical features and abnormalities of circadian rhythm seen in cluster headache. Abnormalities in the secretion of melatonin and cortisol in patients with cluster headache, neuroimaging of cluster headache attacks, and the use of melatonin as preventative therapy in cluster headache are discussed in this review. While the majority of studies exploring the relationship between circadian rhythms and cluster headache are not new, we have entered a new diagnostic and therapeutic era in primary headache disorders. The time has come to use the evidence for a disorder of circadian rhythm in cluster headache to further development of chronobiotics in the treatment of this disorder.

scholarly journals Evidence That HFE H63D Variant Is a Potential Disease Modifier in Cluster Headache

2021 ◽  
Author(s):  
Maria Papasavva ◽  
Michail Vikelis ◽  
Martha-Spyridoula Katsarou ◽  
Vasileios Siokas ◽  
Emmanouil Dermitzakis ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Iron Homeostasis ◽  
Hereditary Hemochromatosis ◽  
Primary Headache ◽  
Headache Disorder ◽  
Allelic Frequency ◽  
Primary Headaches ◽  
Primary Headache Disorder ◽  
Disease Modifier ◽  
Potential Link

AbstractCluster headache (CH) is a primary headache disorder with a complex genetic background. Several studies indicate a potential link between iron homeostasis and the pathophysiology of primary headaches. The HFE gene encodes for a protein involved in iron metabolism, while genetic variants in HFE have been associated with hereditary hemochromatosis (HH), an iron overload disorder. The objective of the current study was to examine the association of the more common HFE H63D variant, with the susceptibility to develop CH and diverse clinical phenotypes in a population of Southeastern European Caucasian (SEC) origin. Genomic DNA samples from 128 CH patients and 294 neurologically healthy controls were genotyped for the HFE rs1799945 (H63D) variant. H63D genotypic and allelic frequency distribution did not differ significantly between patients and controls (p > 0.05). Subgroup analysis revealed a significantly more frequent occurrence of the variant G allele in chronic compared to episodic CH patients, indicative for a possible correlation of the HFE gene with the susceptibility for disease chronification. Although homozygosity for the less prevalent H63D variant G allele was minimal in the CH cohort, the results of the present study are in accordance with previous studies in CH and migraine patients, suggesting that HFE H63D variant modifies the disease clinical characteristics. Hence, despite the absence of a per se association with CH susceptibility in the current SEC cohort, variability in HFE gene may be potentially regarded as a disease modifier genetic factor in CH.

Nocebo is the enemy, not placebo. A meta-analysis of reported side effects after placebo treatment in headaches

Cephalalgia ◽  
2011 ◽  
Vol 31 (5) ◽  
pp. 550-561 ◽  
Author(s):  
Dimos D Mitsikostas ◽  
Leonidas I Mantonakis ◽  
Nikolaos G Chalarakis
Keyword(s):  
Clinical Trials ◽  
Cluster Headache ◽  
Meta Analysis ◽  
Preventive Treatment ◽  
Primary Headache ◽  
Symptomatic Treatment ◽  
Adverse Side Effect ◽  
Primary Headaches ◽  
Nocebo Effect ◽  
Primary Headache Disorders

The aim was to determine the magnitude of the nocebo (adverse effects following placebo administration) in clinical trials for primary headache disorders. We reviewed randomized, placebo-controlled studies for migraine, tension-type headache (TTH), and cluster headache treatments published between 1998 and 2009. The frequency of nocebo was estimated by the percentage of placebo-treated patients reporting at least one adverse side effect. The dropout frequency was estimated by the percentage of placebo-treated patients who discontinued the treatment due to intolerance. In studies of symptomatic treatment for migraine, the nocebo and dropout frequencies were 18.45% and 0.33%, but rose to 42.78% and 4.75% in preventative treatment studies. In trials for prevention of TTH, nocebo and dropout frequencies were 23.99% and 5.44%. For symptomatic treatment of cluster headache, the nocebo frequency was 18.67%. Nocebo is prevalent in clinical trials for primary headaches, particularly in preventive treatment studies. Dropouts due to nocebo effect may confound the interpretation of many clinical trials.

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