Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences



Committee Chair

Amy Fiske.


Previous research suggests that individuals who experience chronic pain are at increased risk for suicidal behaviors. No studies, however, have specifically examined the association between headaches and fatal suicide behavior. Furthermore, it remains unclear whether gender moderates the relation between pain and suicide, and whether the relation is independent of the effects of depression. The present study aimed to characterize the relation between pain (headache, back, shoulder, and neck) and suicide. Data were obtained from two sources in the Swedish Twin Registry. A total of 42,928 individuals responded to headache questions in either 1967 or 1973 for the first data source. The second data source, which began in 1998, consisted of data from 40,912 individuals who responded to questions assessing for back, shoulder and neck pain along with 24,987 individuals who responded to headache questions. Survival analysis using Poisson regression was used to estimate the risk of suicide associated with pain variables. Analyses indicated that women who experienced headaches were two times more likely to die by suicide than women who did not experience headaches. Additionally, men who reported pain were almost four times more likely to die by suicide than men who did not report pain, even after controlling for depressive symptoms. The findings, obtained in one of the largest studies examining pain and prediction of suicide in a population-based sample, support that pain (including headaches) is associated with suicide, and suggest that gender may be an important moderator in the relation between pain and suicide.