Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients

Background: Suicide is a leading cause of death worldwide, affecting ~800,000 people every year. Fibromyalgia is an extremely prevalent rheumatic disease with a predisposition for comorbid anxiety and depression, which are known risk factors for suicidal behavior. Suicidality and relevant risk facto...

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Autores principales:	Mohammad Adawi, Wen Chen, Nicola Luigi Bragazzi, Abdulla Watad, Dennis McGonagle, Yarden Yavne, Adi Kidron, Hadas Hodadov, Daniela Amital, Howard Amital
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	fibromyalgia suicidal ideation and attempt PRISMA guidelines systematic review meta analysis Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/77d2ae0d247b470d970192550a5d1927
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spelling	oai:doaj.org-article:77d2ae0d247b470d970192550a5d19272021-11-19T06:36:45ZSuicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients1664-064010.3389/fpsyt.2021.629417https://doaj.org/article/77d2ae0d247b470d970192550a5d19272021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.629417/fullhttps://doaj.org/toc/1664-0640Background: Suicide is a leading cause of death worldwide, affecting ~800,000 people every year. Fibromyalgia is an extremely prevalent rheumatic disease with a predisposition for comorbid anxiety and depression, which are known risk factors for suicidal behavior. Suicidality and relevant risk factors for suicidal behavior have not been thoroughly studied in patients with fibromyalgia.Objectives: To investigate the risk of suicidal ideation and attempts in patients with fibromyalgia.Methods: A systematic review and meta-analysis was conducted and reported according to the “Preferred Reporting Items for Systematic reviews and Meta-analyses” (PRISMA) standards. Also, the gray literature was extensively searched.Results: Thirteen studies were included in the present systematic review and meta-analysis, including 394,087 fibromyalgia patients. Sample size ranged from 44 to 199,739 subjects, mean age ranged from 45.8 to 54.5 years while the female percentage with fibromyalgia ranged from 17.1 to 100.0%. The overall suicide ideation prevalence was 29.57% (95%CI 1.84–72.07), with an OR 9.12 of (95%CI 1.42–58.77), ranging from 2.34 (95%CI 1.49–3.66) to 26.89 (95%CI 5.72–126.42). Pooled suicide attempt prevalence was 5.69% [95%CI 1.26–31.34], with an OR of 3.12 [95%CI 1.37–7.12]. Suicide risk was higher with respect to the general population with an OR of 36.77 (95%CI 15.55–96.94), as well as suicide events with an HR of 1.38 (95%CI 1.17–1.71). Determinants of suicidality were found to be: employment status, disease severity, obesity and drug dependence, chronic pain and co-morbidities, in particular depression, anxiety, poor sleep, and global mental health. However, in some cases, after adjusting for psychiatric conditions, the threshold of statistical significance was not achieved.Conclusion: Fibromyalgia patients are particularly prone to suicide, in terms of ideation, attempt, risk and events, warranting a pre-emptive screening of their mental health status. Given the few studies available, the high amount of heterogeneity, the evidence of publications bias and the lack of statistical significance when adjusting for underlying psychiatric co-morbidities, further high-quality studies should be conducted.Clinical Trial Registration:ClinicalTrial.gov, identifier 10.17605/OSF.IO/Y4BUE.Mohammad AdawiWen ChenNicola Luigi BragazziNicola Luigi BragazziNicola Luigi BragazziAbdulla WatadAbdulla WatadAbdulla WatadAbdulla WatadDennis McGonagleYarden YavneYarden YavneYarden YavneAdi KidronAdi KidronAdi KidronHadas HodadovDaniela AmitalHoward AmitalHoward AmitalHoward AmitalFrontiers Media S.A.articlefibromyalgiasuicidal ideation and attemptPRISMA guidelinessystematic reviewmeta analysisPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	fibromyalgia suicidal ideation and attempt PRISMA guidelines systematic review meta analysis Psychiatry RC435-571
spellingShingle	fibromyalgia suicidal ideation and attempt PRISMA guidelines systematic review meta analysis Psychiatry RC435-571 Mohammad Adawi Wen Chen Nicola Luigi Bragazzi Nicola Luigi Bragazzi Nicola Luigi Bragazzi Abdulla Watad Abdulla Watad Abdulla Watad Abdulla Watad Dennis McGonagle Yarden Yavne Yarden Yavne Yarden Yavne Adi Kidron Adi Kidron Adi Kidron Hadas Hodadov Daniela Amital Howard Amital Howard Amital Howard Amital Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients
description	Background: Suicide is a leading cause of death worldwide, affecting ~800,000 people every year. Fibromyalgia is an extremely prevalent rheumatic disease with a predisposition for comorbid anxiety and depression, which are known risk factors for suicidal behavior. Suicidality and relevant risk factors for suicidal behavior have not been thoroughly studied in patients with fibromyalgia.Objectives: To investigate the risk of suicidal ideation and attempts in patients with fibromyalgia.Methods: A systematic review and meta-analysis was conducted and reported according to the “Preferred Reporting Items for Systematic reviews and Meta-analyses” (PRISMA) standards. Also, the gray literature was extensively searched.Results: Thirteen studies were included in the present systematic review and meta-analysis, including 394,087 fibromyalgia patients. Sample size ranged from 44 to 199,739 subjects, mean age ranged from 45.8 to 54.5 years while the female percentage with fibromyalgia ranged from 17.1 to 100.0%. The overall suicide ideation prevalence was 29.57% (95%CI 1.84–72.07), with an OR 9.12 of (95%CI 1.42–58.77), ranging from 2.34 (95%CI 1.49–3.66) to 26.89 (95%CI 5.72–126.42). Pooled suicide attempt prevalence was 5.69% [95%CI 1.26–31.34], with an OR of 3.12 [95%CI 1.37–7.12]. Suicide risk was higher with respect to the general population with an OR of 36.77 (95%CI 15.55–96.94), as well as suicide events with an HR of 1.38 (95%CI 1.17–1.71). Determinants of suicidality were found to be: employment status, disease severity, obesity and drug dependence, chronic pain and co-morbidities, in particular depression, anxiety, poor sleep, and global mental health. However, in some cases, after adjusting for psychiatric conditions, the threshold of statistical significance was not achieved.Conclusion: Fibromyalgia patients are particularly prone to suicide, in terms of ideation, attempt, risk and events, warranting a pre-emptive screening of their mental health status. Given the few studies available, the high amount of heterogeneity, the evidence of publications bias and the lack of statistical significance when adjusting for underlying psychiatric co-morbidities, further high-quality studies should be conducted.Clinical Trial Registration:ClinicalTrial.gov, identifier 10.17605/OSF.IO/Y4BUE.
format	article
author	Mohammad Adawi Wen Chen Nicola Luigi Bragazzi Nicola Luigi Bragazzi Nicola Luigi Bragazzi Abdulla Watad Abdulla Watad Abdulla Watad Abdulla Watad Dennis McGonagle Yarden Yavne Yarden Yavne Yarden Yavne Adi Kidron Adi Kidron Adi Kidron Hadas Hodadov Daniela Amital Howard Amital Howard Amital Howard Amital
author_facet	Mohammad Adawi Wen Chen Nicola Luigi Bragazzi Nicola Luigi Bragazzi Nicola Luigi Bragazzi Abdulla Watad Abdulla Watad Abdulla Watad Abdulla Watad Dennis McGonagle Yarden Yavne Yarden Yavne Yarden Yavne Adi Kidron Adi Kidron Adi Kidron Hadas Hodadov Daniela Amital Howard Amital Howard Amital Howard Amital
author_sort	Mohammad Adawi
title	Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients
title_short	Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients
title_full	Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients
title_fullStr	Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients
title_full_unstemmed	Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients
title_sort	suicidal behavior in fibromyalgia patients: rates and determinants of suicide ideation, risk, suicide, and suicidal attempts—a systematic review of the literature and meta-analysis of over 390,000 fibromyalgia patients
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/77d2ae0d247b470d970192550a5d1927
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_version_	1718420321427521536

Suicidal Behavior in Fibromyalgia Patients: Rates and Determinants of Suicide Ideation, Risk, Suicide, and Suicidal Attempts—A Systematic Review of the Literature and Meta-Analysis of Over 390,000 Fibromyalgia Patients

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