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Suicidal ideation correlates strongly with depression in patients with fibromyalgia
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In patients with fibromyalgia who did not respond well to treatment, suicidal ideation was common and most strongly associated with depressive symptoms and disease severity, according to recently published data.
Researchers from the University of Granada’s Department of Neurosciences studied 353 women and 20 men who had been diagnosed with fibromyalgia and did not respond satisfactorily to or were intolerant to prior pharmacological treatment in prior clinical studies. Patient demographic data were collected, and each patient was administered the Fibromyalgia Impact Questionnaire (FIQ), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI). In all but one subgroup, the SF-12 Health Survey was administered, and all but two groups of participants were administered the Brief Pain Inventory (BPI) in the earlier studies.
The physical and mental component scores (MCS) of the SF-12 were included if data were present, and the scores of the seven VAS subscales of the FIQ (work difficulty, pain, fatigue, morning tiredness, stiffness, anxiety and depression) were also included.
The researchers determined suicidal ideation by the response to question nine in the BDI. Data from patients who scored “0” in this item (“I don’t have any thoughts of harming myself”) were compared with patients who scored “1” (“I have any thoughts of harming myself but I would not carry them out”), “2” (“I would like to kill myself”) or “3” (“I would kill myself if I had the chance”).
T-tests between suicidal ideation and non-ideation were used, and ANOVA evaluated non-ideation, passive ideation (a score of 1 on the BDI) and active suicidal ideation (scores of 2 or 3). Results were adjusted for age, sex, comorbidity and time since diagnosis using multiple linear regression.
Suicidal ideation was reported by 48% of patients. Of those, 39.7% reported passive suicidal ideation and 8.3% reported active suicidal ideation. No differences were seen in age or disease duration in those reporting passive or active suicidal ideation, according to the researchers.
About half of women (52%) and men (55%) reported no suicidal ideation, whereas 40% of women and 30% of men reported passive suicidal ideation. Active suicidal ideation was reported by 7.9% of women in the study and by 15% of men, a difference that was not considered significant due to the smaller sample size of men.
Evaluation of the seven VAS subgroups revealed significant differences related to missed work, pain, fatigue, anxiety and depression. The effect size was medium-to-large for the BDI, total FIQ score, FIQ anxiety and depression subscales, PSQI and MCS, according to the researchers.
High levels of anxiety or depression were reported in 88.2% of patients, and suicidal ideation was reported in 96.1% of that group and in only 3.9% of patients categorized and having low anxiety or depression. Only a weak association was seen between suicidal ideation and pain. – by Shirley Pulawski
Disclosures: The researchers report no relevant financial disclosures.
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