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A Systematic Review and Meta-Analysis of Migraine and Suicidal Ideation.

ABSTRACT: BACKGROUND:Previous studies have demonstrated an association between migraine and major depressive disorder. However, relatively little is known about the relationship between suicidal ideation, with or without concurrent depression, and migraine. OBJECTIVE:We conducted a systematic literature review to synthesize the available research focused on investigating the association of migraine with suicidal ideation. METHODS:Relevant research papers were identified through searches of major electronic databases including PubMed, Embase (Elsevier), Web of Science (Thomson Reuters), PsycINFO (EBSCO), and Google Scholar. We performed a meta-analysis to estimate the pooled unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between migraine and suicidal ideation extracted from each study. RESULTS:A total of 148,977 participants in 6 studies were included in this analysis. Overall, findings from available studies documented elevated odds of suicidal ideation among individuals with migraines. In unadjusted models, the odds of suicidal ideation was 2.49-fold higher among individuals with migraine (OR, 2.49; 95% CI, 2.34-2.65) compared with those without migraine. In multivariate-adjusted models, the pooled adjusted OR of suicidal ideation was 1.31 (OR, 1.31; 95% CI, 1.10-1.55). CONCLUSIONS:A meta-analysis of available studies suggests a modest positive association between migraine and suicidal ideation. Further studies allowing for a more comprehensive investigation of the association between migraine and the full range of suicidal behaviors are warranted. A larger and more robust evidence-base may be useful to inform the clinical screening and diagnoses of comorbid conditions in migraineurs.

SUBMITTER: Friedman LE

PROVIDER: S-EPMC5357206 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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A Systematic Review and Meta-Analysis of Migraine and Suicidal Ideation.

Friedman Lauren E LE Gelaye Bizu B Bain Paul A PA Williams Michelle A MA

The Clinical journal of pain 20170701 7

<h4>Background</h4>Previous studies have demonstrated an association between migraine and major depressive disorder. However, relatively little is known about the relationship between suicidal ideation, with or without concurrent depression, and migraine.<h4>Objective</h4>We conducted a systematic literature review to synthesize the available research focused on investigating the association of migraine with suicidal ideation.<h4>Methods</h4>Relevant research papers were identified through searc ...[more]

PMID: 27648590

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Project description:Importance:Suicidal ideation is a widespread phenomenon. However, many individuals at risk for suicide do not seek treatment, which might be addressed by providing low-threshold, internet-based self-help interventions. Objective:To investigate whether internet-based self-help interventions directly targeting suicidal ideation or behavior are associated with reductions in suicidal ideation. Data Sources:A systematic search of PsycINFO, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and the Centre for Research Excellence of Suicide Prevention (CRESP) databases for trials from inception to April 6, 2019, was performed, supplemented by reference searches. Search strings consisted of various search terms related to the concepts of internet, suicide, and randomized clinical trials. Study Selection:Two independent researchers reviewed titles, abstracts, and full texts. Randomized clinical trials evaluating the effectiveness of internet-based self-help interventions to reduce suicidal ideation were included. Interventions were eligible if they were based on psychotherapeutic elements. Trials had to report a quantitative measure of a suicide-specific outcome. Mobile-based and gatekeeper interventions were excluded; no further restrictions were placed on participant characteristics or date of publication. Data Extraction and Synthesis:This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Risk of bias was evaluated using the Cochrane Risk of Bias Tool. Standardized mean differences were calculated using a random-effects model. Main Outcomes and Measures:Suicidal ideation was the a priori primary outcome. Results:Six unique eligible trials (1567 unique participants; 1046 [66.8%] female; pooled mean [SD] age, 36.2 [12.5] years) were included in the systematic review and meta-analysis. All identified interventions were internet-based cognitive behavioral therapy (iCBT). Participants assigned to the iCBT condition experienced a significantly reduced suicidal ideation compared with controls following intervention in all 6 trials (standardized mean difference, -0.29; 95% CI, -0.40 to -0.19; P?<?.001). Heterogeneity was low (I2?=?0%). The effect appeared to be maintained at follow-up in 4 trials (standardized mean difference, -0.18; 95% CI, -0.34 to -0.02; P?=?.03; I2?=?36%). Studies did not report sufficient data on completed suicides and suicide attempts to assess potential associations. Conclusions and Relevance:These results show that iCBT interventions are associated with significant reductions in suicidal ideation compared with control conditions. Considering their high scalability, iCBT interventions have the potential to reduce suicide mortality. Future research should assess the effect of these digital health interventions on suicidal behavior and identify moderators and mediators to advance understanding of the mechanisms of effectiveness of these interventions.

Project description:Importance:Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies. Objective:To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students. Data Sources and Study Selection:Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included. Data Extraction and Synthesis:Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. Main Outcomes and Measures:Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview. Results:Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n?=?116?628) and 16 longitudinal studies (n?=?5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37?933/122?356 individuals; 95% CI, 24.7% to 29.9%, I2?=?98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982-2015; slope, 0.2% increase per year [95% CI, -0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during medical school (n?=?2432), the median absolute increase in symptoms was 13.5% (range, 0.6% to 35.3%). Prevalence estimates did not significantly differ between studies of only preclinical students and studies of only clinical students (23.7% [95% CI, 19.5% to 28.5%] vs 22.4% [95% CI, 17.6% to 28.2%]; P?=?.72). The percentage of medical students screening positive for depression who sought psychiatric treatment was 15.7% (110/954 individuals; 95% CI, 10.2% to 23.4%, I2?=?70.1%). Suicidal ideation prevalence data were extracted from 24 cross-sectional studies (n?=?21?002) from 15 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of suicidal ideation was 11.1% (2043/21?002 individuals; 95% CI, 9.0% to 13.7%, I2?=?95.8%). Summary prevalence estimates ranged across assessment modalities from 7.4% to 24.2%. Conclusions and Relevance:In this systematic review, the summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%. Further research is needed to identify strategies for preventing and treating these disorders in this population.

Project description:IntroductionCOVID-19 has profoundly impacted the mental health and well-being of pregnant women worldwide. In Ethiopia, the poor sleep quality and suicidal ideation among pregnant women has increased due to the COVID-19 pandemic. This study aimed to provide comprehensive evidence on the prevalence and associated factors of poor sleep quality and suicidal ideation among pregnant women during COVID-19 in Ethiopia.Materials and methodsThis study is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendation. Data were searched from PubMed, Google Scholar, and African Journals Online from the occurrence of the COVID-19 pandemic to February 2023. Two researchers extracted the data and performed the methodological quality assessment independently. Random-effect model was used to estimate the pooled effect size and I2was used to check heterogeneity. Stata 14.0 (StataCorp, Collage Station, Texas, USA) was used for statistical analysis.ResultsFrom six studies the pooled prevalence of poor sleep quality was 55% (95% CI [0.42-0.69], I2 = 98.1%, p < 0.001). Age ≥ 30 years pooled AOR = 1.95, 95% CI (0.85, 3.06), 3rd trimester pooled AOR = 3.20, 95% CI (1.82, 4.58), substance use pooled AOR = 2.51, 95% CI (0.99, 4.04), depression pooled AOR = 2.97, 95% CI (0.92, 5.02) and stress pooled AOR 2.14, 95% CI (0.24, 4.03) were associated factors of poor sleep quality. Three studies reported about suicidal ideation and pooled prevalence was 11% (95% CI: 0.09, 0.13, I2 = 48.2%, p = 0.145). Depression pooled AOR = 3.19, 95% CI (1.68, 4.71) was the only associated factor of suicidal ideation.ConclusionDue to COVID-19 pregnant women in Ethiopia were affected by poor sleep quality and suicidal ideation. Thus, suitable and well designed programs proposing awareness of COVID-19, mental health counseling and involvement should be designed to improve the general mental health of pregnant women.Trial registrationPROSPERO registration number CRD42023389896.

Project description:BackgroundSuicidal ideation is a highly prevalent condition. There are several barriers for individuals to seek treatment that may be addressed by providing internet-based self-help interventions (ISIs). Current evidence suggests that ISIs for mental disorders may only be effective in reducing suicidal ideation if they specifically target suicidal thoughts or behaviors.ObjectiveThe aim of this systematic review and meta-analysis is to investigate the effectiveness of ISIs that directly target suicidal thoughts or behaviors.MethodsWe will conduct a sensitive systematic literature search in PsycINFO, MEDLINE, the Cochrane Central Register of Controlled Trials, and the Centre for Research Excellence of Suicide Prevention databases. Only randomized controlled trials evaluating the effectiveness of ISIs for suicide prevention will be included. Interventions must be delivered primarily in a Web-based setting; mobile-based interventions and interventions targeting gatekeepers will be excluded. Suicide ideation will be the primary outcome; secondary outcomes will be completed suicides, suicide attempts, depressiveness, anxiety, and hopelessness. Study quality will be assessed using the Cochrane Risk of Bias tool. We will provide a narrative synthesis of included studies. If studies are sufficiently homogenous, we will conduct a meta-analysis of the effectiveness on suicide ideation and, if possible, we will evaluate publication bias using funnel plots. We will evaluate the cumulative evidence in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework.ResultsThis review is in progress, with findings expected by August 2019.ConclusionsThis systematic review and meta-analysis focuses on the effectiveness of ISIs for suicidal thoughts and behaviors. It will provide guidance to clinical practice and encourage further research by synthesizing the best available evidence.Trial registrationInternational Prospective Register of Systematic Reviews (PROSPERO) CRD42019130253; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130253.International registered report identifier (irrid)PRR1-10.2196/14174.

Dataset Information

A Systematic Review and Meta-Analysis of Migraine and Suicidal Ideation.

Publications

A Systematic Review and Meta-Analysis of Migraine and Suicidal Ideation.

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