Il a été accepté par beaucoup dans la communauté médicale pendant de nombreuses années que la fibromyalgie est un syndrome de douleur chronique, pas même une maladie. Et certainement pas tuer quelqu’un. Cependant, il y a eu des rapports sporadiques dans la littérature sur l’augmentation de la mortalité due aux maladies cardiovasculaires et au suicide. Une étude publiée l’année dernière dans “Arthritis and Rheumatism” a trouvé des tendances inquiétantes dans une cohorte de patients atteints de fibromyalgie qui peuvent changer l’approche de la communauté de la fibromyalgie de soins de santé.
Les principaux résultats de cette étude chez 1 269 patientes de Dansih étaient les risques accrus de décès dus au suicide, aux maladies du foie et aux maladies cérébrovasculaires. Fait troublant, le risque de suicide chez les patients atteints de fibromyalgie était dix fois plus élevé que celui de la population générale. Cependant, aucun des patients fibromyalgiques qui se sont suicidés n’avait des antécédents médicaux de dépression ou d’autres maladies psychiatriques au moment du diagnostic. Ceci est d’intérêt en ce que les études précédentes ont trouvé des taux accrus de dépression, d’anxiété, de douleur, de fatigue et d’autres troubles psychiatriques.
Il y a une tendance à la sous-déclaration en matière de suicide, peu importe le pays. L’incidence du suicide est affectée par l’intégration sociale et l’imitation. Au Danemark, il y a un manque relatif de la stigmatisation souvent entourant le suicide; et ceci, ajouté au fait que des autopsies sont nécessaires en cas de suspicion de suicide, semblerait assurer des estimations assez précises du taux de suicide.
Ce risque suicidaire plus élevé peut avoir une certaine relation avec le taux plus élevé de décès accidentel chez les patients atteints de fibromyalgie: Il se peut très bien qu’un décès apparemment «accidentel» soit en réalité un suicide (par exemple, une chute ou un seul véhicule) accident). Un diagnostic de douleur chronique est associé à une mortalité accrue due à une variété de causes externes.
Une augmentation du taux de mortalité due à une maladie du foie dans la fibromyalgie peut être liée à la consommation d’alcool. Selon l’Organisation mondiale de la santé, le Danemark a un taux élevé de consommation d’alcool. De plus, la douleur semblable à la fibromyalgie est souvent rapportée par les patients atteints d’hépatite C.
Le taux accru de maladie cérébrovasculaire chez les patients atteints de fibromyalgie peut être dû au fait que de nombreux patients atteints de fibromyalgie sont en surpoids, voire obèses. En fait, 19% des patients atteints de fibromyalgie étaient obèses et 54% étaient des fumeurs actuels – plus de la moitié de ces gros fumeurs. Les sujets sains ont démontré une meilleure réponse cardiovasculaire au stress physique et émotionnel. Bien sûr, l’inactivité physique due à la douleur peut contribuer à l’athérosclérose.
Les médecins doivent rechercher des facteurs de risque de suicide, de maladie du foie et de maladie cérébrovasculaire chaque fois qu’un patient atteint de fibromyalgie se présente pour une évaluation. C’est un peu plus de travail, mais plus que la douleur chronique devra probablement être traitée par le patient et le fournisseur.
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