Increased suicide risk, but not overall mortality, with fibromyalgia

Patients who have been diagnosed with fibromyalgia have about the same mortality risk as the general population, but their risk of suicide or accidental death is elevated, according to a new study.

The analysis included more than 8,000 patients who had been seen by a physician for fibromyalgia between 1974 and 2009. They were compared to a control set of more than 12,000 patients with osteoarthritis as well as death rates for the general U.S. population, adjusted for age and sex. The results were published online by Arthritis Care & Research last week.

During the study period, 539 of the fibromyalgia patients died. The mortality rate was not significantly different from that of the osteoarthritis patients or the U.S. general population. However, the fibromyalgia patients were more than three times more likely than average to commit suicide and they had a 45% increased risk of accidental death. Patients who met the American College of Rheumatology's 2010 criteria for fibromyalgia—which would indicate greater severity of symptoms—did have an increased overall risk of death (hazard ratio, 1.62, 95% CI 1.19 to 2.21).

The study's results confirm previous European research finding no increased mortality for fibromyalgia patients, but differ from studies that have found increased deaths in patients who had widespread pain, which were attributed to cancer. This study found no increased cancer mortality in fibromyalgia patients.

The increase in suicide risk could actually be even higher than calculated, because other research has found that about 20% of accidental deaths may actually be suicides, the authors of the study noted. The authors did not suggest any possible explanations for the suicide risk and they cautioned that the study should not be understood to suggest that fibromyalgia causes suicide, since the findings are associative, not causative.