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Mini Review | DOI: https://doi.org/Emeritus Professor of Psychiatry, New York, USA.
*Corresponding Author: Saeed Shoja Shafti, Emeritus Professor of Psychiatry, New York, USA.
Citation: Saeed S. Shafti, (2024), Narrative Review: Suicide Risk in Headache, Pulsatile Tinnitus, And Cognitive Decline, Psychology and Mental Health Care, 9(2): DOI:10.31579/2637-8892/320
Copyright: © 2024, Saeed Shoja Shafti. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 04 January 2025 | Accepted: 18 February 2025 | Published: 26 February 2025
Keywords: headache; pulsatile tinnitus; cognitive decline; neurovascular pain; suicide risk factors; screening; prevention
Suicide has become a serious concern that presents a significant public health issue worldwide, with nearly 800,000 incidents occurring annually, according to the World Health Organization (WHO). Because its causes tend to be multifactorial, with varying comorbidities and precipitating factors, it is challenging to accurately predict the exact risk of suicide rate. This narrative review explores some of these underlying factors, particularly headache, pulsatile tinnitus, and cognitive decline, and their association with an increase in suicide risk. The review incorporates peer-reviewed publications from the past 20 years to explore contributing factors involving these neurovascular pain and cognitive impairment. Key findings from the literature reveal a substantial correlation between chronic headaches, particularly migraines, and heightened suicidal risk. This suggests that the debilitating nature of these conditions may exacerbate psychological distress and contribute to suicidal ideation. This review emphasizes the need for holistic and multidisciplinary approaches that address both the physical and psychological health of patients with chronic headaches, highlighting the importance of early intervention to mitigate suicide risk. Additionally, the effectiveness and suitability of screening methods for detecting suicide risk and depression in individuals with these conditions are examined.
No doubt speech is one of the most important tools of human beings for communication and mutual understanding of concepts, intents, or feelings. On the other hand, and disregarding the biological basis of talk and communiqué, while women may be declared by some folks to be more verbose than men, some researchers have seen the difference in the way men and women talk as a result of the different conditions they may face because a methodic study has shown that, naturally, females and males both spoke a similar number of words per day (1). However, another study's findings revealed that although men were quantitatively chattier than women, they exhibited more assertive speech compared to females, who used more affiliative speech (2). Also, while it may seem that women are more accurate at reading nonverbal communication than men, according to a psychometric study, men engage in more positive body talk than women (3). Likewise, consistent with the findings of a meta-analysis, while females communicate more concretely than males when a hearer is labeled as being psychologically close, males speak more abstractly than females (4). Additionally, while the processing pattern observed for non-vocal sounds was largely comparable between males and females, sex differences for vocal sounds suggest that women were more sensitive to their social relevance (5). Furthermore, some studies have shown that while females often use chat as a way to generate and sustain relationships, seeking connection and support through dialogue, males tend to use dialogue as a means of asserting status and independence and often use conversation to convey data and exhibit knowledge. Similarly, while topics most linked with female participants included family, friends, and social life, topics most connected with male participants included anger, swearing, use of argumentative language, and discussion of objects instead of people. Besides, while the. Language used more by female samples was interpersonally warmer, more sympathetic, and courteous; language used by males was, comparatively, colder, more hostile, and impersonal. Also, contrary to the aforementioned study (2), women were slightly more assertive than male participants (6). In addition, as stated by the results of another study as regards the autobiographical memory, narrators' gender alone could be the best predictor for recollections of past speech because females used more reported speech than did males (7). On the other hand, some other studies indicated that there were no gender differences in levels of self-evolvement, and the tendency towards separateness or inclusion may be related more to individual differences and other issues such as sociocultural factors and surroundings (8). Anyhow, disregarding the conclusions of systematic studies regarding gender-related differences or resemblances in conversation, at least in some cultures, women may traditionally be acknowledged as more chatty in comparison with men, a belief or misbelief that may be intensified, inadvertently, by some TV series, talk-shows, cultural gossips, or incidental events. In any case, sometimes, during counseling sessions, a counselor or marital therapist may come across a weird rationalization by one of the partners, which, though seems superficial, may have caused great familial challenges. Accordingly, some spouses, usually women, may assert that since their mates have not talked to them satisfactorily, efficiently, or compassionately during their relationship, they have cheated on them as a retaliatory, mandatory, or demonstrative maneuver. On the other hand, though disloyalty usually demands a complex constellation of motives, causes, and explanations, including personal, sociocultural, or financial reasons, highlighting talking as the first and most important reason for justification of an adulterous affair, independently and by itself, may seem erratic for commonsensical or realistic mindsets. In addition, though a sympathetic psychotherapist may have enough experience or empathy for acceptance of such an explanation, a guidance counselor with obsessive-compulsive, narcissistic, or paranoid traits may totally undervalue or discount such a cause because it may seem to them to be too shallow for such a big slip. Similarly, while relatives or companions, consistent with their specific mentalities, may evaluate such a reason in different ways, common people appraise social or familial complications, customarily and at the outset, emotionally, not thoroughly. Nevertheless, by all accounts, why, disregarding sexual life, talking may be so important, at least for some partners, that its absence may end in some serious complications like disloyalty? For sure, in such a situation, the subjective inference of a counselor, which is not independent from apperception, personal character, knowledge, and past experience, may play an important role in his or her final formulation of the case and management of plausible countertransference in himself or herself. On the other hand, while a busy or inattentive housewife may take a shortage of chatting as an advantage for taking care of kids, food, or household, a narcissistic, avoidant, or dubious spouse may interpret that as an insult, inattention, or sarcasm, respectively. Similarly, while a dependent partner may rationalize and accept that at all times and in all places, a histrionic companion may demand that, essentially and romantically, in special circumstances, like a party or day out. Likewise, though a schizoid mate may totally ignore that, a schizotypal partner may take it emblematically. Such a premise may be generalized, approximately, to psychotic patients, with impaired reality-testing or judgement, to depressed patients, with a lowered self-esteem and negative outlook, to maniac cases, with euphoria and irritability, or people with problematic intellect, as well (9, 10). But, disregarding psychopathology, and in spite of the fact that conversation is the most important tool of verbal communication, lack of chat may not end in so harmful complications without the existence of problems in other areas (12-16), especially non-verbal communication, which may be sensed as easily as, and as fast as, the verbal communication, by a sensitive or worried partner. Surely, non-verbal communication may be regarded as the core means of communication for mute partners. On the other hand, though tiredness, preoccupation, or moroseness may influence both verbal and non-verbal communications, their impact is mostly episodic and demarcated, not persistent and generalized. In addition, many times some unfriendly alterations in behavior, pose, or grimace may make silence agonizing for an irritated or guarded partner. Then again, while quietness may be apprehensive for some nervous companions, it may be used or misused as an excuse and sign of detachment for untrustworthy spouses, too. Thus, while, amid such a challenge, some complainers may search for a reason or solution, other objectors may search for an immediate replacement of their mates or sex objects, maybe because their own emotional detachment, if there was any, has been completed before. Practically, it seems unlikely that unfaithfulness may happen for merely silence and without involvement of other covert or overt motives. Anyhow, whether as an actual, particular, or allegorical cause, the challenging couples may demand a solution for their complications, including unsatisfactory chat or care. At this point, improvement of relationship is achieved by enhancement or modification of communicative skills, including conversational and behavioral abilities, diminishing insinuative gestures, substituting unsympathetic catchphrases by caring speeches, turning confrontational atmosphere into an accommodating milieu, and replacing individual unfeasible or eccentric wishes or demands by sensible or functional shared goals. But it is not deniable that all the said valuable maneuvers may be applicable or helpful if at least some degree of warmth exists between the partners. Moreover, given the intuitive nature of love, no technique may induce straightforwardly a factual affection or turn a deep-seated hate into a dreamy adoration. On the other hand, while exhibitive or vocal expression of love, which may be mediated by fiscal, traitorous, or mandatory motives, is easier than an inner committed sense of adore, management of a counseling session may not be a stress-free task, especially for an inexperienced counselor who has never personally experienced such a problematic situation. Sometimes, even the most experienced counselors may not be able to formulate narrated events or manage expressed difficulties without a high degree of uncertainty, which is generally based on chronological gaps, conscious or unconscious gaffes, or subjective judgments of irritated clients. Anyhow, since counseling demands every counselor or psychotherapist to be more considerate, not interrogative, an empathic, not sympatric, a natural, not prejudiced, and a dedicated, not thoughtless aide, if the complaint encompasses only chitchat, then its solution may not be regarded as a hard task.
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