Patients with fibromyalgia may have a heightened risk of death as a result of vulnerability to accidents, infections and, especially, suicide, researchers have warned.
The results suggest ‘fibromyalgia should be taken seriously’ with a need for regular monitoring of patients’ physical and mental health to minimise these risks, they concluded.
Published in the journal RMD Open, the systematic review of eight studies covering more than 188,000 patients found a 27% increased risk of death from all causes for patients diagnosed with the condition under more modern criteria from 2010 onwards.
All the adults in the review had other co-existing conditions, the researchers said, and they also reported a 44% increased risk of infections, including pneumonia and septicaemia, and more than three times the risk for suicide.
For accidents, the risk was 5% higher, but the risk of death from cancer was 12% lower than it was for the general population of the same age.
Whether the heightened risk is due to the fibromyalgia itself or the concomitant conditions is unclear, but it is an important finding that needs to be looked at in further research, the authors concluded.
Fibromyalgia prevalence increasing
It’s not clear what causes fibromyalgia, but its prevalence is increasing and there is growing recognition that the condition often coexists with other health problems, including rheumatic, gut, neurological and mental health disorders.
The higher risk of suicide could potentially be explained by the physical, and especially the psychiatric, comorbidities that are characteristic of fibromyalgia patients, the researchers said.
And increased mortality associated with accidents could stem from fatigue, unrefreshing sleep and the concentration difficulties linked to the condition.
When it comes to infection, increasing evidence supports immune system involvement and inflammation in the development of fibromyalgia, they added.
‘A serious public health problem’
The risks identified in their analysis ‘could represent a serious public health problem, given the high prevalence of the condition’, which clinicians don’t always take seriously, they wrote.
‘Studies have shown that medical staff are reluctant to accept fibromyalgia as a medical condition, and they face emotional and psychological difficulties interacting with these patients and coping with their disorder.
‘Our review provides further proof that fibromyalgia patients should be taken seriously, with particular focus on screening for suicidal ideation, prevention of accidents, and prevention and treatment of infections.’
A 2020 study by UK researchers found an increased risk of self-harm associated with some rheumatic conditions, particularly fibromyalgia where the incidence was found to be highest.
Author of this 2020 study, Carolyn Chew-Graham, a GP and professor of general practice research at Keele University, said: ‘In our research we concluded clinicians need to be aware of the potential for self-harm in patients with rheumatic conditions (particularly fibromyalgia), explore mood and risk with them, and offer appropriate support and management.’