Journal Article Annotations
2021, 4th Quarter
Annotations by Liliya Gershengoren, MD MPH
The authors evaluate the risk of suicidal ideation, behaviour, and attempt amongs patients with fibromyalgia. Findings indicate that factors including employment status as well as comorbidities such as obesity, drug dependence, anxiety, poor sleep, and, in particular, depression, all contributed to the overall risk of suicide in fibromyalgia patients. Importantly, the authors note that fibromyalgia was not shown to have an independent association with suicidal ideation or attempts when the confounding effect of the aforementioned comorbidities were accounted for. Suicidality was found to be associated with the severity of functional impairment of fibromyalgia, but not associated with quality or intensity of pain. As such, the chronic condition of fibromyalgia alone is not associated with an increased risk of suicidality; rather, its comorbidities, mainly psychiatric, typically contribute to the increase in suicidality.
Strength and weaknesses:
This study is a systematic review and meta-analysis which was conducted with methodological rigor in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses– Protocol” (PRISMA-P) guidelines. The authors describe their extensive literature search, cross-checking, and cross-referencing processes. Limitations include heterogeneity among studies in the diagnostic criteria utilized for fibromyalgia and definitions of suicidality as well as variable use of validated assessment tools or self-report questionnaires.
The study has practical implications for CL psychiatrists and rheumatologists who are working with patients diagnosed with fibromyalgia. It offers relevant guidance when assessing suicide risk factors in patients who have fibromyalgia and the importance of screening for psychiatric comorbidities as well as factors such as quality of sleep, functional impairment, and employment status.