NEW YORK (Reuters Health) – People with severe headaches or other forms of chronic pain may have an increased risk of suicide, a study published Tuesday suggests.

The study, of nearly 5,700 U.S. adults, found that those who reported chronic pain other than arthritis were four times more likely to have attempted suicide than adults not suffering from persistent pain.

Head pain and pain in multiple areas of the body were particularly linked to suicidal thoughts and behavior, according to researchers at the University of Michigan Ann Arbor.

They found that men and women with frequent or severe headaches were twice as likely to have either contemplated or attempted suicide.

These risks were also elevated among study participants who reported multiple forms of pain.

Among those with three or more painful conditions, 14 percent said they had ever thought about suicide, while nearly 6 percent reported an actual suicide attempt. [p 3, Table 1]

“Pain is one of those factors that may make someone feel more hopeless and less optimistic about the future and increases the chances that they will think about suicide,” lead researcher Dr. Mark A. Ilgen said in a written statement.

The vast majority of people with painful health conditions will not become suicidal, noted Ilgen, a psychologist at the Ann Arbor VA Hospital.

However, the findings do bolster evidence of a higher-than-average suicide risk among people in chronic pain, Ilgen and his colleagues report in the journal General Hospital Psychiatry.

Studies have, for example, found that migraine sufferers have heightened risks of depression and suicidal behavior. [p 4, par 2]

In the current study, just under 8 percent of people who reported frequent or severe headaches said they had thought about committing suicide, compared with 2 percent of adults with no chronic head pain.

[Table 1]

Even when the researchers accounted for other factors — such as whether participants suffered from any psychiatric disorder — pain itself remained linked to suicidal behavior.

“This is further evidence that we need to be aware of the heightened risk for suicide in those with chronic pain,” Ilgen said. “More work is needed to figure out who’s going to be at the greatest risk and how can we intervene and decrease this risk.”

SOURCE: General Hospital Psychiatry, November/December 2008.