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Abstract Details

Suicide in Veterans with Post-Traumatic Headache: An Analysis of Health Systems Data
Headache
P14 - Poster Session 14 (11:45 AM-12:45 PM)
2-001
While PTH and SRB risk factors are prevalent among Veterans, whether PTH is associated with increased risk of SRBs is unclear.
Evaluate the association of post-traumatic headache (PTH) with suicide-related behaviors (SRBs) compared to matched controls and explore psychiatric diagnoses and headache disease severity as mediators.
This study extracted data from Veterans Health Administration (VHA) electronic health record data sources. Veterans diagnosed with PTH by a physician or APRN during the study period (fiscal years 2008-2020) were included. Non-headache controls were matched on gender, race/ethnicity, age (+/- 5 years), and year and point of care.  Logistic regression evaluated differences in SRBs between the PTH group and matched controls. Diagnoses of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and insomnia, and headache disease severity (operationalized as neurology consultation), were explored separately as potential mediators between PTH and SRBs.
Out of 51,755 Veterans diagnosed with PTH, 6,447 (12.5%) reported any SRB compared to 5,150 matched controls (5%). The PTH group was predominantly White, Non-Hispanic (64.5%) male (89.4%) with an average age of 41 (interquartile Range= 30 – 56). Veterans with PTH had increased odds of any SRB (OR = 2.72, 95% confidence interval [CI] 2.62, 2.82) compared to controls. Results remained significant (OR= 1.80, 95% CI 1.72, 1.87) after adjusting for age, substance use disorders, and the Charlson Comorbidity Index. Significant mediation was observed; the percentages mediated were as follows: MDD (49.4%), PTSD (41.0%), headache disease severity (15.8%), and insomnia (11.8%).
PTH was significantly associated with SRBs; mental health diagnoses and headache disease severity contributed to this relationship. Suicide risk mitigation strategies must be integrated into clinical practice for clinicians treating PTH patients, including addressing headache disease severity and comorbid mental health concerns, particularly MDD and PTSD.
Authors/Disclosures
Sarah Anthony, Other (Headache Center of Excellence)
PRESENTER
Ms. Anthony has nothing to disclose.
Manali Phadke (Yale University) Manali Phadke has nothing to disclose.
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine) Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Xiao M. Androulakis, MD (University of South Carolina) The institution of Dr. Androulakis has received research support from VA rehabilitation research .
Hamada Hamid Altalib, DO (VA Connecticut Healthcare System) The institution of Dr. Altalib has received research support from UCB. The institution of Dr. Altalib has received research support from Eisai. The institution of Dr. Altalib has received research support from Sunovian. The institution of Dr. Altalib has received research support from DEPARTMENT OF DEFENSE - CONGRESSIONALLY DIRECTED MEDICAL RESEARCH PROGRAMS.
Brenda Fenton Brenda Fenton has nothing to disclose.
Jason J. Sico, MD, FAAN Dr. Sico has nothing to disclose.
Elizabeth Seng, PhD (Yeshiva University, Albert Einstein College of Medicine) Dr. Seng has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for GlaxoSmithKline. Dr. Seng has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Click Therapeutics. The institution of Dr. Seng has received research support from NINDS.