Fibromyalgia, Suicide and Attempted Suicide in
Calandre et al. studied suicide and attempted suicide amongst fibromyalgia patients in Spain. They noted that depression, chronic pain and sleep disturbances often co-exist in fibromyalgia. These “have shown to be independently related with suicidal behaviours.” Their survey study showed that 16.7% of the study patients “reported one to three previous suicide attempts.” The most common method used in attempts was drug poisoning (70%). Suicided attempters had significantly higher FIQR scores. There was a high positive correlation between FIQR and Plutchik suicide risk scale scores.
Furthermore, “Pain, poor sleep quality, anxiety and depression were positively correlated with suicide risk.” They concluded that in their survey group “FM is associated with an increased risk of suicide and suicide attempts. Suicidal behaviour seems to be related with the global severity of the disease.” (Suicide attempts and risk of suicide in patients with fibromyalgia: a survey in Spanish patients Elena P. Calandre1, Juan S. Vilchez1, Rocío Molina-Barea1, Maria Isabel Tovar1, Juan M. Garcia-Leiva1, Javier Hidalgo1, Carmen Maria Rodriguez-Lopez1 and Fernando Rico-Villademoros1, Rheumatology (Oxford). 2011 Oct;50(10):1889-93, available in full online at: http://rheumatology.oxfordjournals.org/content/50/10/1889.long.)
A Canadian study by Ratcliffe et al. demonstrated a significant association between migraine, arthritis, back problems, or fibromyalgia and 12-month suicidal ideation or attempt. This was after controlling for mood/anxiety disorders, substance dependence, and socio-demographic variables. (Chronic pain conditions and suicidal ideation and suicide attempts: an epidemiologic perspective Ratcliffe GE, Enns MW, Belik SL, Sareen J.. Clin J Pain. 2008;24:204–210. [PubMed] [Google Scholar]
The obvious conclusion seems to be that misery can reach a level that is difficult to tolerate. It would seem to be very important to try to create hope by finding treatments that have a reasonable chance of working. This is often possible. For example, some patients may feel they are at a dead end, but upon review it is clear that many of there pain follow bad sleep or stress and they never had an organized program to try to rebuild their sleep with CBT-I.
Some have been told that we do not know what causes fibromyalgia. It seems that this could create a feeling of hopeless bewilderment. However, it is now largely untrue. Fibromyalgia as of 2020 is no longer a complete mystery. In the last 20 years there have been many serious studies that have shed light on it. For example, we now know of the importance of central sensitization.