Child Psychiatry & Human Development

, Volume 45, Issue 1, pp 110–118 | Cite as

Do Headache and Abdominal Pain in Childhood Predict Suicides and Severe Suicide Attempts? Finnish Nationwide 1981 Birth Cohort Study

  • Terhi Luntamo
  • Andre Sourander
  • David Gyllenberg
  • Lauri Sillanmäki
  • Minna Aromaa
  • Tuula Tamminen
  • Kirsti Kumpulainen
  • Irma Moilanen
  • Jorma Piha
Original Article

Abstract

This study investigated associations between pain symptoms in mid-childhood and severe suicidality in adolescence and early adulthood. Severe suicidality was defined as completed suicide or suicidal attempt requiring hospital admission. In a nationwide prospective population-based study (n = 6,017), parents and children were asked about the child’s headache and abdominal pain at age eight. The outcome was register-based data on suicide or suicidal attempt requiring hospital treatment by age 24. Family composition, parental educational level, and the child’s psychiatric symptoms reported by the child, parents and teacher at baseline were included as covariates in statistical analyses. Boys’ abdominal pain reported by the parents was associated with later severe suicidality after adjusting for family composition, parental educational level, and childhood psychiatric symptoms at baseline. In addition, the association between boys’ own report of headache and later severe suicidality reached borderline significance in unadjusted analysis. Girls’ pain symptoms did not predict later severe suicidality.

Keywords

Children Pain Prospective studies Suicide 

Notes

Acknowledgments

The study was supported by the Sigrid Juselius Foundation. The funder had no role in the study design, data collection, data analysis, interpretation of data, in the writing of the report, or in the decision to submit the report for publication. We thank Hans Helenius, MSc, for assistance in the statistical matters.

Conflict of interest

The authors have no conflicts of interest to declare with regard to this manuscript.

References

  1. 1.
    Suicide prevention information (2011) World Health Organization Web site. http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/. Accessed 11 Nov 2011
  2. 2.
    Apter A, Bleich A, King RA, Kron S, Fluch A, Kotler M et al (1993) Death without warning? A clinical postmortem study of suicide in 43 Israeli adolescent males. Arch Gen Psychiatr 50:138–142PubMedCrossRefGoogle Scholar
  3. 3.
    Brent DA, Baugher M, Bridge J, Chen T, Chiappetta L (1999) Age- and sex-related risk factors for adolescent suicide. J Am Acad Child Adolesc Psychiatr 38:1497–1505CrossRefGoogle Scholar
  4. 4.
    Marttunen MJ, Aro HM, Henriksson MM, Lönnqvist JK (1991) Mental disorders in adolescent suicide. DSM-III-R axes I and II diagnoses in suicides among 13- to 19-year-olds in Finland. Arch Gen Psychiatr 48:834–839PubMedCrossRefGoogle Scholar
  5. 5.
    Qin P (2011) The impact of psychiatric illness on suicide: differences by diagnosis of disorders and by sex and age of subjects. J Psychiatr Res 45:1445–1452PubMedCrossRefGoogle Scholar
  6. 6.
    Renaud J, Berlim MT, Séguin M, McGirr A, Tousignant M, Turecki G (2009) Recent and lifetime utilization of health care services by children and adolescent suicide victims: a case-control study. J Affect Disord 117:168–173PubMedCrossRefGoogle Scholar
  7. 7.
    Miranda R, Scott M, Hicks R, Wilcox HC, Harris Munfakh JL, Shaffer D (2008) Suicide attempt characteristics, diagnoses, and future attempts: comparing multiple attempters to single attempters and ideators. J Am Acad Child Adolesc Psychiatr 47:32–40CrossRefGoogle Scholar
  8. 8.
    Breslau N, Davis GC, Andreski P (1991) Migraine, psychiatric disorders, and suicide attempts: an epidemiologic study of young adults. Psychiatr Res 37:11–23CrossRefGoogle Scholar
  9. 9.
    Fishbain DA, Goldberg M, Rosomoff RS, Rosomoff H (1991) Completed suicide in chronic pain. Clin J Pain 7:29–36PubMedCrossRefGoogle Scholar
  10. 10.
    Ilgen MA, Zivin K, McCammon RJ, Valenstein M (2008) Pain and suicidal thoughts, plans and attempts in the United States. Gen Hosp Psychiatr 30:521–527CrossRefGoogle Scholar
  11. 11.
    Keefe FJ, Lefebvre JC, Egert JR, Affleck G, Sullivan MJ, Caldwell DS (2000) The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing. Pain 87:325–334PubMedCrossRefGoogle Scholar
  12. 12.
    Knaster P, Karlsson H, Estlander AM, Kalso E (2011) Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain. Gen Hosp Psychiatr 34:46–52CrossRefGoogle Scholar
  13. 13.
    Lee P, Zhang M, Hong JP, Chua HC, Chen KP, Tang SW et al (2009) Frequency of painful physical symptoms with major depressive disorder in asia: relationship with disease severity and quality of life. J Clin Psychiatr 70:83–91CrossRefGoogle Scholar
  14. 14.
    Magni G, Rigatti-Luchini S, Fracca F, Merskey H (1998) Suicidality in chronic abdominal pain: an analysis of the Hispanic Health and Nutrition Examination Survey (HHANES). Pain 76:137–144PubMedCrossRefGoogle Scholar
  15. 15.
    Woolley SB, Fredman L, Goethe JW, Lincoln AK, Heeren T (2008) Headache complaints and the risk of suicidal thoughts or behaviors. J Nerv Ment Dis 196:822–828PubMedCrossRefGoogle Scholar
  16. 16.
    Sourander A, Helstelä L, Haavisto A, Bergroth L (2001) Suicidal thoughts and attempts among adolescents: a longitudinal 8-year follow-up study. J Affect Disord 63:59–66PubMedCrossRefGoogle Scholar
  17. 17.
    Sourander A, Klomek AB, Niemelä S, Haavisto A, Gyllenberg D, Helenius H et al (2009) Childhood predictors of completed and severe suicide attempts: findings from the Finnish 1981 Birth Cohort Study. Arch Gen Psychiatr 66:398–406PubMedCrossRefGoogle Scholar
  18. 18.
    van Tilburg MA, Spence NJ, Whitehead WE, Bangdiwala S, Goldston DB (2011) Chronic pain in adolescents is associated with suicidal thoughts and behaviors. J Pain 12:1032–1039PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Wang SJ, Juang KD, Fuh JL, Lu SR (2007) Psychiatric comorbidity and suicide risk in adolescents with chronic daily headache. Neurology 68:1468–1473PubMedCrossRefGoogle Scholar
  20. 20.
    Fearon P, Hotopf M (2001) Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. BMJ 322:1145PubMedCrossRefGoogle Scholar
  21. 21.
    Hotopf M, Carr S, Mayou R, Wadsworth M, Wessely S (1998) Why do children have chronic abdominal pain, and what happens to them when they grow up? Population based cohort study. BMJ 316:1196–2000PubMedCrossRefGoogle Scholar
  22. 22.
    Merikangas KR, Merikangas JR, Angst J (1993) Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res 27:197–210PubMedCrossRefGoogle Scholar
  23. 23.
    Luntamo T, Sourander A, Sillanmäki L, Gyllenberg D, Aromaa M, Kumpulainen K et al (2012) Pain at age eight as a predictor of antidepressant medication use by age 24: findings from the Finnish nationwide 1981 birth cohort study. J Affect Disord 138:153–159PubMedCrossRefGoogle Scholar
  24. 24.
    Achenbach TM, Howell CT, McConaughy SH, Stanger C (1995) Six-year predictors of problems in a national sample of children and youth: II. Signs of disturbance. J Am Acad Child Adolesc Psychiatr 34:488–498CrossRefGoogle Scholar
  25. 25.
    Almqvist F, Ikäheimo K, Kumpulainen K, Tuompo-Johansson E, Linna SL, Puura K et al (1999) Design and subjects of a Finnish epidemiological study on psychiatric disorders in childhood. Eur Child Adolesc Psychiatr 8(suppl 4):3–6CrossRefGoogle Scholar
  26. 26.
    Rutter M, Tizard J, Whitmore K (eds) (1970) Education, health and behaviour. Longman, LondonGoogle Scholar
  27. 27.
    Beautrais AL (2003) Suicide and serious suicide attempts in youth: a multiple-group comparison study. Am J Psychiatr 160:1093–1099PubMedCrossRefGoogle Scholar
  28. 28.
    Causes of death. Statistics (2011) Finland Web site. http://www.stat.fi/meta/til/ksyyt_en.html. Accessed 11 Nov 2011
  29. 29.
    Sund R (2012) Quality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health 40:505–515PubMedCrossRefGoogle Scholar
  30. 30.
    Luntamo T, Sourander A, Rihko M, Aromaa M, Helenius H, Koskelainen M, McGrath PJ (2012) Psychosocial determinants of headache, abdominal pain, and sleep problems in a community sample of Finnish adolescents. Eur Child Adolesc Psychiatr 21:301–313CrossRefGoogle Scholar
  31. 31.
    Luntamo T, Sourander A, Santalahti P, Aromaa M, Helenius H (2012) Prevalence changes of pain, sleep problems and fatigue among 8-year-old children: years 1989, 1999, and 2005. J Pediatr Psychol 37:307–318PubMedCrossRefGoogle Scholar
  32. 32.
    Kovacs M (1992) Children’s Depression Inventory, CDI, manual. Multi-Health Systems Ontario, CanadaGoogle Scholar
  33. 33.
    Brent D, Weersing VR (2008) Depressive disorders in childhood and adolescence. In: Rutter M, Bishop D, Pine D, Scott S, Stevenson J, Taylor EA et al (eds) Rutter’s child and adolescent psychiatry, 5th edn. Blackwell Publishing, Oxford, p 588Google Scholar
  34. 34.
    Kresanov K, Tuominen J, Piha J, Almqvist F (1998) Validity of child psychiatric screening methods. Eur Child Adolesc Psychiatr 7:85–95CrossRefGoogle Scholar
  35. 35.
    Rutter M (1967) A children’s behaviour questionnaire for completion by teachers: preliminary findings. J Child Psychol Psychiatr 8:1–11CrossRefGoogle Scholar
  36. 36.
    Hirji KF, Mehta CR, Patel NR (1987) Computing distributions for exact logistic regression. J Am Stat Assoc 82:1110–1117CrossRefGoogle Scholar
  37. 37.
    Almqvist F, Kumpulainen K, Ikäheimo K, Linna SL, Henttonen I, Huikko E, Tuompo-Johansson E, Aronen E, Puura K, Piha J, Tamminen T, Räsänen E, Moilanen I (1999) Behavioural and emotional symptoms in 8–9-year-old children. Eur Child Adolesc Psychiatr 8(Suppl 4):7–16CrossRefGoogle Scholar
  38. 38.
    Sourander A, Jensen P, Davies M, Niemelä S, Elonheimo H, Ristkari T, Helenius H, Sillanmäki L, Piha J, Kumpulainen K, Tamminen T, Moilanen I, Almqvist F (2007) Who is at greatest risk of adverse long-term outcomes? The Finnish From a Boy to a man study. J Am Acad Child Adolesc Psychiatr 46:1148–1161CrossRefGoogle Scholar
  39. 39.
    Sourander A, Haavisto A, Ronning JA, Multimäki P, Parkkola K, Santalahti P, Nikolakaros G, Helenius H, Moilanen I, Tamminen T, Piha J, Kumpulainen K, Almqvist F (2005) Recognition of psychiatric disorders, and self-perceived problems. A follow-up study from age 8 to age 18. J Child Psychol Psychiatr 46:1124–1134CrossRefGoogle Scholar
  40. 40.
    Roth-Isigkeit A, Thyen U, Stöven H, Schwarzenberger J, Schmucker P (2001) Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics 115:e152–e162CrossRefGoogle Scholar
  41. 41.
    Petersen S, Hägglöf BL, Bergström EI (2009) Impaired health-related quality of life in children with recurrent pain. Pediatrics 124:e759–e767PubMedCrossRefGoogle Scholar
  42. 42.
    Mallen CD, Mottram S, Thomas E (2009) Is childhood pain associated with future mental health problems? A population based study of young adults in North Staffordshire. Soc Psychiatr Psychiatr Epidemiol 44:489–494CrossRefGoogle Scholar
  43. 43.
    Penttinen J (1995) Back pain and risk of suicide among Finnish farmers. Am J Public Health 85:1452–1453PubMedCrossRefGoogle Scholar
  44. 44.
    van Heeringen C, Audenaert K, Van Laere K, Dumont F, Slegers G, Mertens J et al (2003) Prefrontal 5-HT2a receptor binding index, hopelessness and personality characteristics in attempted suicide. J Affect Disord 74:149–158PubMedCrossRefGoogle Scholar
  45. 45.
    Stahl S, Briley M (2004) Understanding pain in depression. Hum Psychopharmacol 19(Suppl 1):S9–S13PubMedCrossRefGoogle Scholar
  46. 46.
    Juang KD, Wang SJ, Fuh JL, Lu SR, Chen YS (2004) Association between adolescent chronic daily headache and childhood adversity: a community-based study. Cephalalgia 24:54–59PubMedCrossRefGoogle Scholar
  47. 47.
    Pickles A, Aglan A, Collishaw S, Messer J, Rutter M, Maughan B (2010) Predictors of suicidality across the life span: the Isle of Wight study. Psychol Med 40:1453–1466PubMedCrossRefGoogle Scholar
  48. 48.
    Brown RJ (2004) Psychological mechanisms of medically unexplained symptoms: an integrative conceptual model. Psychol Bull 130:793–812PubMedCrossRefGoogle Scholar
  49. 49.
    Conrad R, Schilling G, Bausch C, Nadstawek J, Wartenberg HC, Wegener I et al (2007) Temperament and character personality profiles and personality disorders in chronic pain patients. Pain 133:197–209PubMedCrossRefGoogle Scholar
  50. 50.
    Garnefski N, Legerstee J, Kraaij VV, Van Den Kommer T, Teerds J (2002) Cognitive coping strategies and symptoms of depression and anxiety: a comparison between adolescents and adults. J Adolesc 25:603–611PubMedCrossRefGoogle Scholar
  51. 51.
    Williams N, Jackson D, Lambert PC, Johnstone JM (1999) Incidence of non-specific abdominal pain in children during school term: population survey based on discharge diagnoses. BMJ 318:1455PubMedCrossRefGoogle Scholar
  52. 52.
    Pool GJ, Schwegler AF, Theodore BR, Fuchs PN (2007) Role of gender norms and group identification on hypothetical and experimental pain tolerance. Pain 129:122–129PubMedCrossRefGoogle Scholar
  53. 53.
    Beautrais AL (2002) Gender issues in youth suicidal behaviour. Emerg Med 14:35–42CrossRefGoogle Scholar
  54. 54.
    Smith MT, Edwards RR, Robinson RC, Dworkin RH (2004) Suicidal ideation, plans, and attempts in chronic pain patients: factors associated with increased risk. Pain 111:201–208PubMedCrossRefGoogle Scholar
  55. 55.
    Gradus JL, Qin P, Lincoln AK, Miller M, Lawler E, Sørensen HT et al (2010) Inflammatory bowel disease and completed suicide in Danish adults. Inflamm Bowel Dis 16:2158–2161PubMedCrossRefGoogle Scholar
  56. 56.
    Loftus EV Jr, Guérin A, Yu AP, Wu EQ, Yang M, Chao J et al (2011) Increased risks of developing anxiety and depression in young patients with Crohn’s disease. Am J Gastroenterol 106:1670–1677PubMedCrossRefGoogle Scholar
  57. 57.
    Paras ML, Murad MH, Chen LP, Goranson EN, Sattler AL, Colbenson KM et al (2009) Sexual abuse and lifetime diagnosis of somatic disorders: a systematic review and meta-analysis. JAMA 302:550–561PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Terhi Luntamo
    • 1
  • Andre Sourander
    • 1
  • David Gyllenberg
    • 1
    • 2
  • Lauri Sillanmäki
    • 1
  • Minna Aromaa
    • 3
  • Tuula Tamminen
    • 4
  • Kirsti Kumpulainen
    • 5
  • Irma Moilanen
    • 6
  • Jorma Piha
    • 1
  1. 1.Department of Child PsychiatryUniversity of TurkuTurkuFinland
  2. 2.Department of Child Psychiatry, Helsinki University HospitalUniversity of HelsinkiHelsinkiFinland
  3. 3.Department of Public Health, University of Turku, Finland and Child and Adolescent Health Care Unit, Turku City HospitalTurkuFinland
  4. 4.Department of Child Psychiatry, Tampere University HospitalUniversity of TampereTampereFinland
  5. 5.Department of Child Psychiatry, Kuopio University HospitalUniversity of Eastern FinlandKuopioFinland
  6. 6.Department of Child Psychiatry, Oulu University HospitalUniversity of OuluOuluFinland

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