Fibromialgia e morte | O que você precisa saber

Muitos anos a comunidade médica aceitou que a fibromialgia é uma síndrome da dor crônica – nem mesmo uma doença. E certamente não matando ninguém. No entanto, houve relatos esporádicos na literatura de aumento da mortalidade por doenças cardiovasculares e suicídio. Um estudo publicado no ano passado em “Arthritis and Rheumatism” encontrou tendências perturbadoras em uma coorte de pacientes com fibromialgia que podem mudar a abordagem da comunidade de saúde para a fibromialgia.

As principais conclusões deste estudo de 1.269 mulheres do tipo Dansih foram o aumento dos riscos de morte por suicídio, doença hepática e doença cerebrovascular. Perturbadamente, o risco de suicídio entre os pacientes com fibromialgia foi dez vezes maior que o da população em geral. No entanto, nenhum dos pacientes com fibromialgia que cometeu suicídio teve uma história médica de depressão ou outra doença psiquiátrica no momento do diagnóstico. Isto é de interesse em que estudos anteriores encontraram taxas aumentadas de depressão, ansiedade, dor, fadiga e outros distúrbios psiquiátricos.

Existe uma tendência para uma subnotificação quando se trata de suicídio, independentemente do país. A incidência do suicídio é impactada pela integração e imitação social. Na Dinamarca, há uma falta relativa do estigma que muitas vezes envolve o suicídio; e isso, juntamente com o fato de que as autópsias são necessárias quando se suspeita de um suicídio, parece assegurar estimativas bastante precisas da taxa de suicídio.

Este maior risco de suicídio pode ter alguma relação com a maior taxa de morte acidental em pacientes com fibromialgia: muito bem pode ser o caso de uma morte aparentemente “acidental” na realidade ser um suicídio (por exemplo, uma queda ou um único veículo acidente). O diagnóstico de dor crônica está associado ao aumento da mortalidade devido a uma variedade de causas externas.

Uma taxa de mortalidade aumentada devido a doença hepática na fibromialgia pode estar relacionada ao consumo de álcool. De acordo com a Organização Mundial de Saúde, a Dinamarca possui uma alta taxa de consumo de álcool. Além disso, a dor com fibromialgia é freqüentemente relatada por pacientes com hepatite C.

O aumento da taxa de doença cerebrovascular em pacientes com fibromialgia pode ser devido ao fato de que muitos pacientes com fibromialgia estão acima do peso, se não obesos. Na verdade, 19% dos pacientes com fibromialgia eram obesos e 54% eram fumantes atuais – mais da metade desses fumantes pesados. Os indivíduos saudáveis ​​demonstraram uma melhor resposta cardiovascular ao estresse físico e emocional. Claro, a inatividade física devido à dor pode contribuir para a aterosclerose.

Os médicos precisam buscar fatores de risco de suicídio, doença hepática e doença cerebrovascular sempre que um paciente com fibromialgia apresentar para uma avaliação. É um pouco mais de trabalho, mas mais do que a dor crônica provavelmente terá que ser abordada pelo paciente e pelo provedor.

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