Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Outpatient Engagement Lowers Suicide Risk in FM

Arthritis Care Res; ePub 2018 Sep 7; McKernan, et al

Fibromyalgia (FM) patients are 10 times more likely to die by suicide than the general population, according to a recent study that aimed to externally validate published models predicting suicidal ideation and attempts in FM and identify interpretable risk and protective factors for suicidality unique to FM. Researchers conducted a case‐control study of large‐scale electronic health records (EHR) data collected from 1998‐2017, identifying FM cases with validated Phenotype Knowledgebase (PheKB) criteria. They identified 8,879 individuals with FM, with 34 known suicide attempts and 96 documented cases of suicidal ideation. They found:

  • Risk factors specific to suicidal ideation included polysomatic complaints such as fatigue, dizziness, and weakness.
  • Risk factors specific to suicide attempt included obesity and drug dependence.
  • Per utilization analyses, those with FM and no suicidal ideation spent 3.5 times more time in follow‐up annually, and those without documented suicide attempts spent >40 times more time face‐to‐face with providers annually.


McKernan LC, Lenert MC, Crofford LJ, Walks CG. Outpatient engagement lowers predicted risk of suicide attempts in fibromyalgia. [Published online ahead of print September 7, 2018]. Arthritis Care Res. doi:10.1002/acr.23748.

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