Friday, January 28, 2011

Mortality in Fibromyalgia

Note: In some areas, the assumption is that if a disease doesn't kill
you directly it isn't important. Medicine's failure to adequately and
safely address, define and determine the etiology of severe pain and
other organic issues coupled with a lack of hope for patients could
easily be blamed for suicide rates in fibromyalgia, which were shown
by the study below to be similar for patients with osteoarthritis. As
with AIDS, it isn't the virus that actually kills the patient, it is
the associated variables and diseases.

Fibromyalgia: What's Killing Us?
Wednesday January 26, 2011

Newly published research shows that fibromyalgia does not cause
premature death.  However, the illness does raise the risk of suicide
and accidental death.

Researchers followed a group of nearly 8,200 fibromyalgia patients and
more than 10,000 osteoarthritis patients for 35 years.  They say the
death rate was nearly the same between these two groups.

Earlier research has also shown the higher rate of suicide.  Given the
high rate of depression, strain on marriage and other relationships,
and the difficulties of treating fibromyalgia, that's sadly to be

The higher rate of accidental death may seem odd, but it does make
sense in light of certain fibromyalgia symptoms.  We tend to be
clumsy, and our cognitive dysfunction (fibro fog) may make it
dangerous for us to drive.  Also, accidental overdose can happen due
to forgetfulness, desperation or both.

The take-aways from this study include:

We don't need to worry about early death as a result of fibromyalgia
(at least, not directly);
We do need to find help for depression and suicidal thoughts;
We need to be careful and pay attention to our physical and mental
capabilities at that moment so we don't put ourselves in danger.

Mortality in fibromyalgia: A study of 8,186 patients over thirty-five years
Frederick Wolfe1,*, Afton L. Hassett2,†, Brian Walitt3, Kaleb Michaud4

To determine if mortality is increased among patients diagnosed as
having fibromyalgia.

We studied 8,186 fibromyalgia patients seen between 1974 and 2009 in 3
settings: all fibromyalgia patients in a clinical practice, patients
participating in the US National Data Bank for Rheumatic Diseases
(NDB), and patients invited to participate in the NDB who refused
participation. Internal controls included 10,087 patients with
osteoarthritis. Deaths were determined by multiple source
communication, and all patients were also screened in the US National
Death Index (NDI). We calculated standardized mortality ratios (SMRs)
based on age- and sex-stratified US population data, after adjustment
for NDI nonresponse.

There were 539 deaths, and the overall SMR was 0.90 (95% confidence
interval [95% CI] 0.61–1.26). Among 1,665 clinic patients, the SMR was
0.92 (95% CI 0.81–1.05). Sensitivity analyses varying the rate of NDI
nonidentification did not alter the nonassociation. Adjusted for age
and sex, the hazard ratio for fibromyalgia compared with
osteoarthritis was 1.05 (95% CI 0.94–1.17). The standardized mortality
odds ratio (OR) compared with the US general population was increased
for suicide (OR 3.31, 95% CI 2.15–5.11) and for accidental deaths (OR
1.45, 95% CI 1.02– 2.06), but not for malignancy.

Mortality does not appear to be increased in patients diagnosed with
fibromyalgia, but the risk of death from suicide and accidents was

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