Wednesday, August 18, 2010

More evidence for fibromyalgia, suicide link

By Genevra Pittman

NEW YORK (Reuters Health) - A study of more than 8,000 Americans with fibromyalgia suggests that they are not at an overall increased risk of dying over a given time compared to people without the chronic pain condition.

Rates of suicide and accidental deaths, however, were higher than average among people with fibromyalgia in the study. Still, the overall risk of suicide was still low and the findings don't prove that fibromyalgia symptoms cause suicide, the authors emphasize.

The results, published in the journal Arthritis Care & Research, come one month after a study of Danish patients with fibromyalgia also found an increased risk of suicide in these patients compared to the general public, but no increased risk of death overall. (See Reuters Health story of July 16, 2010: Fibromyalgia comes with suicide risk: study)

"This is an illness which seems to have major suffering associated with it, but isn't associated with physical changes that lead to increased risk of death," Dr. Frederick Wolfe, the study's lead author from the National Data Bank for Rheumatic Diseases in Wichita, Kansas, told Reuters Health.

Fibromyalgia affects about 2 percent of the U.S. population and is much more common in women than men. People with fibromyalgia suffer from all-over pain and many feel tired all the time. They also have higher-than-average rates of psychiatric illness such as depression or anxiety.

But there has not been definitive data on whether those with the condition have higher rates of death than the general population.

To get at that question, Wolfe and his colleagues tracked patients who had been diagnosed with fibromyalgia between 1974 and 2009. Some of those patients were seen in a local clinic, while others had been referred to the National Data Bank.

The authors collected information on patients' symptoms, including survey responses about their physical and mental health, and kept track of how many patients died from what causes over the course of the study. They were able to follow each patient for an average of 7 years.

Over the course of the study, 539 of the approximately 8,000 fibromyalgia patients died. This is about what would be expected in a similar group of people in the United States without fibromyalgia over a 7-year period.

Accidental deaths were responsible for 7.1 percent of deaths in people with fibromyalgia and 4.4 percent of deaths in these patients were from suicide. In a group of similar age and gender distribution but without fibromyalgia, 5 percent would be expected to die from accidents and 1.4 percent from suicide.

Dr. David Marks, a psychiatrist at Duke University's Durham Regional Hospital in North Carolina who treats patients with fibromyalgia, said he was not surprised by the increased rate of suicide. Like the authors, though, he warned that the overall risk of suicide was still small.

"Unfortunately, (fibromyalgia) is not taken very seriously in the medical community and the community at large," he told Reuters Health. "Sometimes patients don't get a lot of support."

"These patients are very demoralized, they feel very isolated and alone," added Marks, who was not involved with the current research.

Marks speculated that the increased rate in accidental deaths could be due to what's known as "fibro fog," when some people with fibromyalgia "kind of space out," he said.

Marks hopes that the lack of a significant link between fibromyalgia and overall death rates in this study doesn't mean doctors will see the condition as less legitimate. Even if these patients aren't dying any faster than people without fibromyalgia, he said, they're still suffering. And doctors could do more to prevent and ease that suffering.

"I think that overall we could probably do a better job meeting the psychiatric needs of fibromyalgia patients," Marks said. "Fibromyalgia in itself is not just a mood disorder or an anxiety disorder. It is a real phenomenon that needs to be taken more seriously."

SOURCE: Arthritis Care & Research, online July 26.

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