Mortality in a cohort of Danish patients with fibromyalgia: Increased frequency of suicide

Abstract

Objective. A previous study demonstrated an association between self-reported widespread body pain and increased mortality. The aim of this study was to analyze whether fibromyalgia (FM) and FM-like symptoms are related to increased mortality.Methods. From hospital records, we identified 1,361 patients referred during the period 1984-1999 because of the suspicion of FM. The cases were reviewed by reviewers who were blinded to the outcome. The cohort was followed up for a total of 5,295 person-years at risk and was linked to the Danish Mortality Register. Using the number of years at risk and sex-, age-, and calendar-specific mortality rates from the general population, cause-specific standardized mortality ratios [SMRs] were calculated.Results. We observed no overall increased mortality among patients with FM. Among the 1,269 female patients, the SMRs (95% confidence intervals [95% CIs]) for an increased risk of death from suicide, liver cirrhosis/biliary tract disease, and cerebrovascular disease were 10.5 (95% CI 4.5-20.7), 6.4 (95% CI 2.3-13.9), and 3.1 (95% CI 1.1-6.8), respectively. The suicide risk was increased at the time of diagnosis and remained increased after 5 years. Patients meeting the American College of Rheumatology criteria for FM and patients with possible FM had the same cause-specific mortality pattern. No increased cause-specific mortality was observed in the 84 male patients.Conclusion. The causes of a markedly increased rate of suicide among female patients with FM are at present unknown but may be related to increased rates of lifetime depression, anxiety, and psychiatric disorders. Risk factors for suicide should be sought at the time of the diagnosis of FM and at followup. The results also suggest that risk factors for liver disease and cerebrovascular disease should be evaluated in patients with FM.

Fibromyalgia Is Associated With Coronary Heart Disease

“…[1][2][3][4][5][6][7] The conflicting results may be attributable to differences in the populations studied and in the definitions used to identify chronic pain. Most importantly, possible mechanisms underlying the association between fibromyalgia and increased mortality, if any, should be explored.…”

Change in Suicidal Ideation After Interdisciplinary Treatment of Chronic Pain

“…1,2 Several longitudinal epidemiologic investigations have demonstrated significant positive associations between pain conditions and completed suicides. [3][4][5][6] Case control studies of premorbid pain among suicide victims 7,8 and prospective case series studies of pain clinic or rheumatology patients [9][10][11] have also indicated that those with CP have an increased risk of completed suicide.…”

Guidelines for the successful management of fibromyalgia patients

“…50 In a Danish study fibromyalgia patients had suicide rate of 10.5 times that of the general population. 51 Apart from caution in the use of SSRIs, the management of psychiatric disorders in fibromyalgia patients follows the usual guidelines for nonfibromyalgia patients.…”