Suicide

From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history
Jump to: navigation, search

Statistics about suicide among patients with myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) remain widely disparate, possibly because of regional differences in suicide rates in general, as well as the use of different case definitions between epidemiological studies. Some case definitions may capture someone with a depressive disorder instead of ME/CFS and some may exclude a ME/CFS patient because they have a secondary psychiatric disorder. Other factors to consider are the regional and personal support systems available[1], the stigma of suicide which may mask the official cause of death, and whether chronic pain is a presenting symptom.[2][3] Regardless, one question is much discussed among researchers, clinicians, and patients: that the incidence of suicide appears higher in patients with ME and CFS than that of the general population.

Causes[edit | edit source]

The reasons cited for suicide risk in the ME and CFS populations are similar to those in other chronic illness populations: poor quality of life coupled with hopelessness for relief; loss of employment, finances, and/or relationships; chronic pain; secondary depression; and comorbid mental illness and/or physical illnesses.[4][5] In a qualitative study of patients with ME/CFS with suicidal ideation, Devendorf et al. (2018) found the following contributing factors to suicide in non-depressed people with chronic illness:

  • having or lacking resources (79%)
  • social interactions with a lack of understanding (72%)
  • systemic healthcare issues related to treatment of ME/CFS (66%)
  • losing a sense of self due to ME/CFS (59%)
  • illness-induced distress (48%)
  • and other factors[6]

Stigma[edit | edit source]

The stigma of living with a poorly understood chronic ilness may also be a factor.[6] Stigma can reduce social support and increase isolation, which are both factors linked to an increased suicide risk.

Regional studies[edit | edit source]

United States[edit | edit source]

A 2016 study by the Center for Community Research, DePaul University, compared the mortality in patients with myalgic encephalomyelitis and chronic fatigue syndrome to the mortality rates of the general population in the United States. Four categories for death were examined in detail: all causes combined, suicide, cardiovascular-related and cancer. In this study sample of 56 patients, the most frequent cause of death, as reported by caregivers, was suicide, occurring among 26.8% of patients. When examining suicide rates they found the suicide rate was higher in male ME/CFS patients than females (53.33% male and 46.67% female), which was the only cause of death in this study to display this pattern. Although the mean age of death in individuals with ME and CFS is at a younger age compared to the overall population, only the rate of all causes combined and cardiovascular-related mortality reached statistical significance.[7]

United Kingdom[edit | edit source]

A 2016 study by Robert, et al, examined the mortality rates via electronic clinical records of 2147 people with chronic fatigue syndrome (as per the Oxford case definition) over a seven year period who presented to a specialist clinic that serves London and the south of England. The researchers found no significant statistical difference in mortality rate for all-cause mortality or cancer-specific mortality in patients with chronic fatigue syndrome compared with the general population in England and Wales when matched for age and gender. The one category for which a significant increase existed was in suicide-specific mortality. The researchers, also, found an increased risk of completed suicide in patients with chronic fatigue syndrome when compared with a population control. In total, five people died from suicide during the 7-year period.[8] Kapur and Webb, from the Centre for Suicide Prevention at the University of Manchester, UK commented on the Roberts, et al, study: "Based on the suicide rate in the general population of England and Wales, the expected number would have been less than one death by suicide. In other words, suicide risk was increased almost seven-fold."[9]

Because of the statistic analysis used, this study is criticized by Dr. James Coyne, an ardent critic of the statistical analysis of the PACE trial. Please note that several of the researchers who authored this study, authored the PACE trial study.[10]

Spain[edit | edit source]

A 2015 Spanish study founded an increased risk of suicide in ME/CFS patients, 12.75% compared to 2.3% in the general Spanish population. This study is believed to be the first that pointed to external factors, such as, inadequate medical treatment and loss of job and relationships, instead of depression as the motivation for suicide.[11][12][7]

Quotes[edit | edit source]

  • 2016 - "Ultimately the best way to prevent suicide in ME/CFS will be to find effective disease-modifying treatments or cures for it," by Dr. Lily Chu[4]

Notable studies[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. Schwartz-Lifshitz, Maya; Zalsman, Gil; Giner, Lucas; Oquendo, Maria A. (2012), "Can We Really Prevent Suicide?", Current Psychiatry Reports, 14 (6): 624–633, doi:10.1007/s11920-012-0318-3 
  2. Hassett, AL; Aquino, JK; Ilgen, MA (2014), "The risk of suicide mortality in chronic pain patients.", Current Pain & Headache Reports, 18 (8): 436, doi:10.1007/s11916-014-0436-1, PMID 24952608 
  3. Newton-John, TR (2014), "Negotiating the maze: risk factors for suicidal behavior in chronic pain patients", Current Pain & Headache Reports, 18 (9): 447, doi:10.1007/s11916-014-0447-y, PMID 25091131 
  4. 4.04.1 Chu, Lily (May 2016). "Suicide and ME/CFS". IAME/CFS Newsletter. 9 (1). 
  5. 5.05.1 Pederson, Cathy L.; Gorman-Ezell, Kathleen; Hochstetler-Mayer, Greta (Aug 1, 2017). "Invisible Illness Increases Risk of Suicidal Ideation: The Role of Social Workers in Preventing Suicide". Health & Social Work. 42 (3): 183–186. doi:10.1093/hsw/hlx029. ISSN 0360-7283. 
  6. 6.06.16.2 Devendorf, AR; McManimen, SL; Jason, LA (2018). "Suicidal ideation in non-depressed individuals: The effects of a chronic, misunderstood illness". Journal of Health Psychology. doi:10.1177/1359105318785450. 
  7. 7.07.17.2 McManimen, Stephanie L.; Devendorf, Andrew R.; Brown, Abigail A.; Moore, Billie C.; Moore, James H.; Jason, Leonard A. (2016), "Mortality in patients with myalgic encephalomyelitis and chronic fatigue syndrome", Fatigue: Biomedicine, Health & Behavior, 4 (4), doi:10.1080/21641846.2016.1236588 
  8. 8.08.1 Roberts, Emmert; Wessely, Simon; Chalder, Trudie; Chang, Chin-Kuo; Hotopf, Matthew (2016), "Mortality of people with chronic fatigue syndrome: a retrospective cohort study in England and Wales from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) Register", The Lancet, 387 (10028): 1638 - 1643, doi:10.1016/S0140-6736(15)01223-4, PMID 26873808 
  9. 9.09.1 Kapur, Nav; Webb, Roger (2016), "Suicide risk in people with chronic fatigue syndrome", The Lancet, 387 (10028): 1596 - 1597, doi:10.1016/S0140-6736(16)00270-1, PMID 26873809 
  10. https://jcoynester.wordpress.com/2016/02/16/bad-stats-non-sequitur-conclusions-in-lancet-chronic-fatigue-syndromesuicide-study/
  11. "RISK OF SUICIDE DUE TO NEGLECT AMONGST PWME". Plataforma de Afectadas por los Recortes Sanitarios - La PARS (in español). May 11, 2016. Retrieved Jul 27, 2020. 
  12. Jiménez-Ortiz JJ. Depresión y desesperanza en personas enfermas de Encefalomielitis Miálgica/ Síndrome de Fatiga Crónica: Factores de riesgo y de protección. 2015 [cited 2016 Jun 14] Available from: http://uvadoc.uva.es/handle/10324/13868
  13. Pederson, Cathy L. (2018), "The Importance of Screening for Suicide Risk in Chronic Invisible Illness", J Health Sci Educ, 2 (4): 1-5, doi:10.0000/JHSE.1000141 
  14. McKernan, Lindsey C; Lenert, Matthew C; Crofford, Leslie J; Walsh, Colin G (Sep 7, 2018). "Outpatient Engagement Lowers Predicted Risk of Suicide Attempts in Fibromyalgia". Arthritis Care & Research. doi:10.1002/acr.23748. ISSN 2151-464X. 

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

chronic fatigue syndrome (CFS) - A fatigue-based illness. The term CFS was invented invented by the U.S. Centers for Disease Control as an replacement for myalgic encephalomyelitis (ME). Some view CFS as a neurological disease, others use the term for any unexplained long-term fatigue. Sometimes used as a the term as a synonym of myalgic encephalomyelitis, despite the different diagnostic criteria.

chronic fatigue syndrome (CFS) - A fatigue-based illness. The term CFS was invented invented by the U.S. Centers for Disease Control as an replacement for myalgic encephalomyelitis (ME). Some view CFS as a neurological disease, others use the term for any unexplained long-term fatigue. Sometimes used as a the term as a synonym of myalgic encephalomyelitis, despite the different diagnostic criteria.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.