Many in the medical community have accepted for many years that fibromyalgia is a chronic pain syndrome, not even a disease. And certainly not kill anyone. However, there have been sporadic reports in the literature of increased mortality due to cardiovascular disease and suicide. A study published last year in “Arthritis and Rheumatism” found disturbing trends in a cohort of patients with fibromyalgia that can change the focus of the health care community to fibromyalgia.
The main findings of this study of 1,269 female Dansih women were the highest risk of death from suicide, liver disease and cerebrovascular disease. It is disturbing that the risk of suicide among patients with fibromyalgia is ten times greater than that of the general population. However, none of the fibromyalgia patients who committed suicide had a medical history of depression or other psychiatric illness at the time of diagnosis. This is of interest because previous studies have found higher rates of depression, anxiety, pain, fatigue and other psychiatric disorders.
There is a tendency to lack of notification when it comes to suicide, regardless of the country. The incidence of suicide is affected by social integration and imitation. In Denmark, there is a relative lack of stigma that often surrounds suicide; and this, together with the fact that autopsies are required when suicide is suspected, seems to ensure fairly accurate estimates of the suicide rate.
This increased risk of suicide may be related to the higher rate of accidental death in patients with fibromyalgia: it is quite possible that an apparently “accidental” death is actually a suicide (for example, a fall or a single vehicle). accident). A diagnosis of chronic pain is associated with increased mortality due to a variety of external causes.
A higher mortality rate due to liver disease in fibromyalgia may be related to alcohol consumption. According to the World Health Organization, Denmark has a high rate of alcohol consumption. In addition, pain similar to fibromyalgia is often reported by patients with hepatitis C.
The increase in the rate of cerebrovascular disease in patients with fibromyalgia may be due to the fact that many patients with fibromyalgia are overweight, if they are not obese. In fact, 19% of patients with fibromyalgia were obese and 54% were current smokers, more than half of these heavy smokers. Healthy subjects demonstrated a better cardiovascular response to physical and emotional stress. Of course, physical inactivity due to pain may contribute to atherosclerosis.
Physicians need to seek risk factors for suicide, liver disease and cerebrovascular disease whenever fibromyalgia patient presents for an evaluation. It is a little more work, but more than chronic pain will likely need to be addressed by patient and provider.