Fibromyalgia (FM) patients, like those with other chronic conditions, can be at increased risk of suicide or attempted suicide, but this risk is amplified in FM patients with additional diseases, such as heart failure, stroke, anxiety, sleep disorder, headaches or depression, researchers reported.
These findings were detailed in the study, “Increased Risk Of A Suicide Event In Patients With Primary Fibromyalgia And In Fibromyalgia Patients With Concomitant Comorbidities: A Nationwide Population-Based Cohort Study,” published in the journal Medicine.
Previous studies have suggested an association between chronic pain and suicidal thoughts and behavior, and that generalized pain, symptoms of depression and lack of sleep, which frequently affect FM patients, are risk factors for suicide. The existence of other health conditions in these patients can increase this risk. However, evidence of a possible association between suicidal thoughts and FM is limited.
Researchers analyzed data from 95,150 patients with incident FM (mean age, 45.8; female to male ratio of 6:4) and 190,299 control subjects (matched by such things as sex and age), included in the Longitudinal Health Insurance Database, a subset of Taiwan’s insurance claim dataset.
Analysis showed that, compared to the matched subjects, FM patients had a higher incidence of other health conditions, such as diabetes, hypertension, hyperlipidemia, congestive heart failure, cerebrovascular disease, depression, irritable bowel syndrome, headache, sleep disorder, and chronic liver disease.
Researchers found 347 suicides or suicide attempts among FM patients, and 424 among the controls, over a 12-year follow-up. The risk of suicide was higher in the FM group than in the control group, regardless of gender. Also, FM patients with no other health condition had a significant risk of a suicide event (a suicide or an attempt) compared to matched individuals.
The level of suicide risk for patients with primary FM was observed to be similar to that of other patients with chronic diseases, such as diabetes, hypertension, irritable bowel syndrome, and liver cirrhosis. But the risk was lower compared to non-FM patients with other disorders, namely congestive heart failure, cerebrovascular disease, depression, anxiety, headache, or sleep disorder. FM patients with an additional disorder had an increased risk of suicide or a suicide attempt (except FM patients with hyperlipidemia).
“In conclusion, our study confirms that fibromyalgia, a chronic pain disorder, increases the risk of suicidal behavior, whereas the risk in patients with primary fibromyalgia is similar to that in patients with other chronic diseases,” the researchers wrote. “Fibromyalgia patients with concomitant comorbidity of heart failure, stroke, anxiety, headache, sleep disorder, or depression are associated with a markedly enhanced risk of a suicide event.”
They added that it is “of paramount importance to identify fibromyalgia patients with a high suicide risk and provide them with social support and medical treatment to prevent suicidal behavior.”