Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study
Abstract
1. Introduction
2. Methods
2.1. Data Source
2.2. Participants
2.3. Outcome Measurements
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
aHR | adjusted hazard ratio |
CI | confidence interval |
NHIRD | National Health Insurance Research Database |
ICD-9-CM | International Classification of Diseases, Ninth Revision, Clinical Modification |
References
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Status Migrainosus | p-Value | Regular Migraine | p-Value | |||
---|---|---|---|---|---|---|
No | Yes | No | Yes | |||
(N = 54,379) | (N = 13,605) | (N = 85,840) | (N = 21,483) | |||
Sex | 0.95 | 0.95 | ||||
Female | 40,368(74.2) | 10,096(74.2) | 63,386(73.8) | 15,859(73.8) | ||
Male | 14,011(25.8) | 3509(25.8) | 22,454(26.2) | 5624(26.2) | ||
Age stratified (years) | 0.99 | 0.99 | ||||
≤49 | 34,928(64.2) | 8740(64.2) | 56,524(65.9) | 14,145(65.8) | ||
50–64 | 12,843(23.6) | 3211(23.6) | 19,440(22.7) | 4864(22.6) | ||
65+ | 6608(12.2) | 1654(12.2) | 9876(11.5) | 2474(11.5) | ||
Age, mean ± SD a | 45.6(15.1) | 45.7(14.8) | 0.42 | 44.9(15.2) | 45.1(14.8) | 0.23 |
Monthly income (NTD) † | 0.01 | 0.001 | ||||
<15,000 | 20,922(38.5) | 5043(37.1) | 33,192(38.7) | 7959(37.1) | ||
15,000–19,999 | 16,626(30.6) | 4211(31.0) | 25,934(30.2) | 6687(31.1) | ||
≥20,000 | 16,831(31.0) | 4351(32.0) | 26,714(31.1) | 6837(31.8) | ||
Urbanization level ‡ | <0.001 | 0.001 | ||||
1 (highest) | 16,639(30.6) | 3797(27.9) | 26,485(30.9) | 6222(29.0) | ||
2 | 16,363(30.1) | 4251(31.3) | 25,727(30.0) | 6642(30.9) | ||
3 | 9296(17.1) | 2249(16.5) | 14,692(17.1) | 3486(16.2) | ||
4 (lowest) | 12,081(22.2) | 3308(24.3) | 18,936(22.1) | 5133(23.9) | ||
Occupation category & | 0.001 | 0.001 | ||||
Office worker | 28,863(53.1) | 7041(51.8) | 45,943(53.5) | 11,283(52.5) | ||
Laborer | 20,873(38.4) | 5464(40.2) | 32,510(37.9) | 8432(39.3) | ||
Other | 4643(8.54) | 1100(8.09) | 7387(8.61) | 1768(8.23) | ||
Comorbidity | ||||||
Schizophrenia | 511(0.94) | 137(1.01) | 0.47 | 675(0.79) | 184(0.86) | 0.30 |
Depression | 7214(13.3) | 1810(13.3) | 0.91 | 9918(11.6) | 2494(11.6) | 0.82 |
Alcohol-related illness | 2045(3.76) | 519(3.81) | 0.77 | 2881(3.36) | 734(3.42) | 0.66 |
Anxiety | 20,476(37.7) | 5127(37.7) | 0.95 | 30,253(35.2) | 7578(35.3) | 0.93 |
Mental disorders | 6140(11.3) | 1535(11.3) | 0.98 | 9304(10.8) | 2326(10.8) | 0.96 |
Insomnia | 37,477(68.9) | 9379(68.9) | 0.96 | 56,314(65.6) | 14,097(65.6) | 0.97 |
Variable | Event | PY | Rate # | Crude HR (95% CI) | Adjusted HR $ (95% CI) |
---|---|---|---|---|---|
Status migrainosus | |||||
No | 56 | 394,603 | 1.42 | 1.00 | 1.00 |
Yes | 26 | 99,946 | 2.60 | 1.82(1.15, 2.90) * | 1.81(1.14, 2.89) * |
Age group (years) | |||||
≤49 | 68 | 322,343 | 2.11 | 3.10(1.49, 6.45) ** | 3.27(1.56, 6.87) ** |
50–64 | 8 | 117,777 | 0.68 | 1.00 | 1.00 |
65+ | 6 | 54,429 | 1.10 | 1.68(0.58, 4.84) | 1.58(0.55, 4.59) |
Sex | |||||
Female | 73 | 369,296 | 1.98 | 2.74(1.37, 5.47) ** | 2.67(1.31, 5.43) ** |
Male | 9 | 125,253 | 0.72 | 1.00 | 1.00 |
Monthly income (NTD) † | |||||
<15,000 | 40 | 171,388 | 2.33 | 3.14(1.68, 5.87) *** | 2.44(1.24, 4.78) ** |
15,000−19,999 | 29 | 157,796 | 1.84 | 2.36(1.23, 4.54) * | 1.89(0.98, 3.66) |
≥20,000 | 13 | 165,366 | 0.79 | 1.00 | 1.00 |
Urbanization level ‡ | |||||
1 (highest) | 26 | 148,541 | 1.75 | 1.46(0.71, 3.03) | |
2 | 28 | 149,328 | 1.88 | 1.57(0.77, 3.24) | |
3 | 10 | 83,682 | 1.20 | 1.00 | |
4 (lowest) | 18 | 112,999 | 1.59 | 1.33(0.61, 2.87) | |
Occupation category & | |||||
Office worker | 33 | 259,306 | 1.27 | 1.00 | 1.00 |
Laborer | 35 | 194,913 | 1.80 | 1.40(0.87, 2.25) | 1.40(0.86, 2.29) |
Other | 14 | 40,330 | 3.47 | 2.76(1.48, 5.15) ** | 1.88(0.95, 3.69) |
Comorbidity | |||||
Schizophrenia | |||||
No | 79 | 489,986 | 1.61 | 1.00 | 1.00 |
Yes | 3 | 4563 | 6.57 | 4.14(1.31, 13.1) * | 1.76(0.54, 5.73) |
Depression | |||||
No | 54 | 433,365 | 1.25 | 1.00 | 1.00 |
Yes | 28 | 61,184 | 4.58 | 3.85(2.44, 6.08) *** | 2.15(1.27, 3.65) ** |
Alcohol-related illness | |||||
No | 71 | 480,513 | 1.48 | 1.00 | 1.00 |
Yes | 11 | 14,036 | 7.84 | 5.90(3.11, 11.2) *** | 4.32(2.22, 8.41) *** |
Anxiety | |||||
No | 30 | 307,897 | 0.97 | 1.00 | 1.00 |
Yes | 52 | 186,652 | 2.79 | 2.93(1.87, 4.59) *** | 1.95(1.15, 3.31) * |
Mental disorders | |||||
No | 79 | 441,360 | 1.79 | 1.00 | 1.00 |
Yes | 3 | 53,189 | 0.56 | 0.32(0.10, 1.01) | |
Insomnia | |||||
No | 15 | 170,676 | 0.88 | 1.00 | 1.00 |
Yes | 67 | 323,873 | 2.07 | 2.63(1.50, 4.63) *** | 1.91(1.06, 3.46) * |
Variable | Event | PY | Rate # | Crude HR (95% CI) | Adjusted HR $ (95% CI) |
---|---|---|---|---|---|
Regular migraine | |||||
No | 93 | 659,110 | 1.41 | 1.00 | 1.00 |
Yes | 32 | 167,185 | 1.91 | 1.35(0.91, 2.02) | 1.34(0.90, 2.00) |
Age group (years) | |||||
≤49 | 105 | 557,763 | 1.88 | 2.20(1.02, 4.72) * | 2.77(1.28, 6.02) * |
50–64 | 13 | 185,091 | 0.70 | 0.82(0.33, 2.06) | 0.91(0.36, 2.30) |
65+ | 7 | 83,441 | 0.84 | 1.00 | 1.00 |
Sex | |||||
Female | 106 | 616,795 | 1.72 | 1.88(1.16, 3.07) * | 1.77(1.07, 2.93) * |
Male | 19 | 209,501 | 0.91 | 1.00 | 1.00 |
Monthly income (NTD) † | |||||
<15,000 | 58 | 290,561 | 2.00 | 2.69(1.63, 4.44) *** | 1.92(1.11, 3.30) * |
15,000−19,999 | 46 | 260,277 | 1.77 | 2.33(1.39, 3.90) ** | 1.88(1.12, 3.18) * |
≥20,000 | 21 | 275,457 | 0.76 | 1.00 | 1.00 |
Urbanization level ‡ | |||||
1 (highest) | 30 | 251,779 | 1.19 | 1.00 | 1.00 |
2 | 48 | 248,120 | 1.93 | 1.62(1.03, 2.56) * | 1.47(0.93, 2.32) |
3 | 17 | 138,799 | 1.22 | 1.03(0.57, 1.86) | 0.96(0.53, 1.75) |
4 (lowest) | 30 | 187,598 | 1.60 | 1.34(0.81, 2.22) | 1.26(0.75, 2.10) |
Occupation category & | |||||
Office worker | 52 | 439,466 | 1.18 | 1.00 | 1.00 |
Laborer | 50 | 319,046 | 1.57 | 1.32(0.90, 1.95) | 1.18(0.79, 1.78) |
Other | 23 | 67,784 | 3.39 | 2.89(1.77, 4.72) *** | 2.19(1.27, 3.77) ** |
Comorbidity | |||||
Schizophrenia | |||||
No | 118 | 820,075 | 1.44 | 1.00 | 1.00 |
Yes | 7 | 6221 | 11.3 | 7.86(3.67, 16.9) *** | 3.28(1.49, 7.223) ** |
Depression | |||||
No | 84 | 739,827 | 1.14 | 1.00 | 1.00 |
Yes | 41 | 86,469 | 4.74 | 4.30(2.96, 6.25) *** | 2.33(1.51, 3.60) *** |
Alcohol-related illness | |||||
No | 114 | 805,688 | 1.41 | 1.00 | 1.00 |
Yes | 11 | 20,607 | 5.34 | 4.00(2.15, 7.45) *** | 2.61(1.37, 4.96) ** |
Anxiety | |||||
No | 49 | 539,650 | 0.91 | 1.00 | 1.00 |
Yes | 76 | 286,645 | 2.65 | 2.96(2.07, 4.25) *** | 1.87(1.23, 2.86) ** |
Mental disorders | |||||
No | 117 | 741,867 | 1.58 | 1.00 | 1.00 |
Yes | 8 | 84,428 | 0.95 | 0.61(0.30, 1.24) | |
Insomnia | |||||
No | 21 | 314,784 | 0.67 | 1.00 | 1.00 |
Yes | 104 | 511,512 | 2.03 | 3.26(2.03, 5.22) *** | 2.44(1.49, 4.00) *** |
Competing-Risks Regression Models | ||
---|---|---|
Status Migrainosus | ||
No | Yes | |
Status migrainosus | ||
Crude SHR (95% CI) | 1(Reference) | 2.90(1.77, 4.74) *** |
Adjusted SHR † (95% CI) | 1(Reference) | 1.99(1.24, 3.18) ** |
Outcome | Status Migrainosus | Crude HR (95% CI) | Adjusted HR $ (95% CI) | |||
---|---|---|---|---|---|---|
No | Yes | |||||
Event | Rate # | Event | Rate # | |||
Liquid or solid poisoning (ICD-9-CM code E950) | 28 | 0.71 | 19 | 1.90 | 2.66(1.49, 4.76) ** | 2.63(1.47, 4.71) ** |
Charcoal burning and poisoning by gases (ICD-9-CM code E952) | 4 | 0.10 | 1 | 0.10 | 0.98(0.11, 8.77) | 0.96(0.11, 6.60) |
Hanging (ICD-9-CM code E953) | 1 | 0.03 | 2 | 0.20 | 7.79(0.71, 85.9) | 8.09(0.73, 89.3) |
Cutting/piercing (ICD-9-CM code E956) | 8 | 0.20 | 1 | 0.10 | 0.50(0.06, 3.96) | 0.55(0.07, 4.43) |
Jumping from high places (ICD-9-CM code E957) | 2 | 0.05 | 0 | 0.00 | - | - |
Others (ICD-9-CM codes E951, E954, E955, E958, and E959) | 13 | 0.33 | 3 | 0.30 | 0.91(0.26, 3.19) | 0.93(0.27, 3.26) |
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Harnod, T.; Lin, C.-L.; Kao, C.-H. Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study. J. Clin. Med. 2018, 7, 269. https://doi.org/10.3390/jcm7090269
Harnod T, Lin C-L, Kao C-H. Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study. Journal of Clinical Medicine. 2018; 7(9):269. https://doi.org/10.3390/jcm7090269
Chicago/Turabian StyleHarnod, Tomor, Cheng-Li Lin, and Chia-Hung Kao. 2018. "Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study" Journal of Clinical Medicine 7, no. 9: 269. https://doi.org/10.3390/jcm7090269
APA StyleHarnod, T., Lin, C.-L., & Kao, C.-H. (2018). Risk and Predisposing Factors for Suicide Attempts in Patients with Migraine and Status Migrainosus: A Nationwide Population-Based Study. Journal of Clinical Medicine, 7(9), 269. https://doi.org/10.3390/jcm7090269