Chronic fatigue syndrome may be linked to more suicides

There may be a substantial increase in mortality from suicide among people with chronic fatigue syndrome, a British study found.

Researchers investigated mortality in individuals diagnosed with chronic fatigue syndrome (also known as systemic exertion intolerance disease) in secondary and tertiary care in England and Wales using data from National Health Service registries. Study participants were included if they had had contact with the chronic fatigue service (referral, discharge, or case note entry) and received a diagnosis of chronic fatigue syndrome.

Results were published online Feb. 9 by The Lancet.

There were 2,147 cases of chronic fatigue syndrome and 17 deaths from Jan. 1, 2007, to Dec. 31, 2013. Overall, 1,533 patients were women, 11 of whom died, and 614 were men, 6 of whom died. Eight deaths were from malignant neoplasm, 5 were from suicide, and 4 were from other causes.

There was no significant difference in age-standardized and sex-standardized mortality ratios (SMR) for all-cause mortality (SMR, 1.14; 95% CI, 0.65 to 1.85; P=0.67) or cancer-specific mortality (SMR, 1.39; 95% CI, 0.60 to 2.73; P=0.45) in patients with chronic fatigue syndrome when compared with the general population in England and Wales. This remained the case when deaths from suicide were removed from the analysis. There was a significant increase in suicide-specific mortality (SMR, 6.85; 95% CI, 2.22 to 15.98; P=0.002).

“This study highlights the importance of adequate assessment of mood and other psychiatric symptoms in patients with chronic fatigue syndrome, because lifetime diagnosis of depression is an independent risk factor for increased risk of completed suicide in this population,” the authors wrote. “Although completed suicide was a rare event, the findings strengthen the case for robust psychiatric assessment by mental health professionals when managing individuals with chronic fatigue syndrome.”