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Report in Mail on new suicide and ME? study by King's College

Countrygirl

Senior Member
Messages
5,429
Location
UK
Here is an online article for 9th Feb reporting on a study from Wessley's lair;

Some of the comments are an excellent remedy for low blood pressure.

http://www.dailymail.co.uk/health/a...imes-likely-commit-suicide.html?ITO=applenews

People suffering from chronic fatigue syndrome are six times more likely to commit suicide than those unaffected by the condition, a major study has concluded.

The research, published in The Lancet medical journal, is the first to highlight suicide as a major risk factor for the condition, which is also known as M.E.

The findings, by experts at King’s College London, are likely to undermine the arguments of sceptics who claim that chronic fatigue syndrome is nothing more than ‘yuppie flu’.

The team, who analysed the health records of 2,000 patients over seven years, found those with chronic fatigue syndrome were no more likely than anyone else to die from cancer or any other disease - but they had a much higher suicide rate....
Read the rest of the article here.
 
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Hip

Senior Member
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17,824
Only had a quick look, but it looked pretty pointless. So under-powered that it was never going to tell us anything of interest.

What specifically are you saying is wrong with this study that you think invalidates its results?
 
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13,774
What specifically are you saying is wrong with this study that you think invalidates its results?

I'm not saying that the results are invalid, I'm saying that it looked at such a small sample that it was unlikely to be able to detect any of the increased risks of death which we do occasionally see anecdotally reported on here (eg: increased risk of rare forms of cancer). That people with a health problem, especially one as stigmatised and disabling as CFS, are more likely to kill themselves than population norms seems pretty uninteresting too.
 

Hip

Senior Member
Messages
17,824
I'm not saying that the results are invalid, I'm saying that it looked at such a small sample that it was unlikely to be able to detect any of the increased risks of death which we do occasionally see anecdotally reported on here (eg: increased risk of rare forms of cancer).

Obviously larger patient sample would have been better, but within its limitations, to me this latest study seems valid enough for quantifying the suicide prevalence.

It also closely concurs with a previous US study on ME/CFS suicide prevalence, which found the suicide rate was 8 times the national average.



That people with a health problem, especially one as stigmatised and disabling as CFS, are more likely to kill themselves than population norms seems pretty uninteresting too.

Well I found it interesting.
 

Countrygirl

Senior Member
Messages
5,429
Location
UK
Did the study look at the cause of death in different age groups? The anecdotal evidence is that people with ME die on average about 25 years earlier than normal usually from cardiovascular disease and cancer, with the rare Mantle Cell Lymphoma being over-represented. It is strange that they draw the conclusion that people with ME are no more likely to die of cancer than any other group.I would be curious to know if they used the 50-65 age group in long-term ME patients as I wonder if the death rate is above average with heart disease and cancer.
 

Sasha

Fine, thank you
Messages
17,863
Location
UK
Did the study look at the cause of death in different age groups? The anecdotal evidence is that people with ME die on average about 25 years earlier than normal usually from cardiovascular disease and cancer, with the rare Mantle Cell Lymphoma being over-represented. It is strange that they draw the conclusion that people with ME are no more likely to die of cancer than any other group.I would be curious to know if they used the 50-65 age group in long-term ME patients as I wonder if the death rate is above average with heart disease and cancer.

IIRC that "25 years" figure was based on a study of people who died early (or a study whose methodology would mean that that's the population that was looked at). There's a lot of misunderstanding about its interpretation and it doesn't suggest that PWME die 25 years earlier, on average.
 
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15,786
Sonya Chowdhury said:
‘Having such a long-term, chronic, debilitating illness undoubtedly affects emotional and mental well-being and our team regularly responds to calls and enquiries from people who are in desperate need and sometimes suicidal.’
Suicide in the case of chronic biomedical illness probably doesn't have much to do with "emotional and mental well-being", but rather with the complete neglect of symptomatic treatment or physical support.
 

Hip

Senior Member
Messages
17,824
So people suffering from a terrible life destroying illness are more prone to committing suicide?

The study did a bit more that just find ME/CFS patients were "more" prone to committing suicide. They quantified the suicide rate (as being 6.85 times higher than normal). That then makes it possible to compare to other diseases, like multiple sclerosis, where one study found the suicide rate is 2 times higher than normal, or schizophrenia, where the suicide rate is around 60 times higher than normal. 1

Though I agree that I'd prefer to see the King's College psychologists or psychiatrists focus on epidemiological studies like these, rather than proposing implausible psychological etiologies of ME/CFS.



The anecdotal evidence is that people with ME die on average about 25 years earlier than normal usually from cardiovascular disease and cancer

I have never heard any such anecdotal evidence. I have heard people say things like this before, but have not seen the evidence.

Though I have seen studies like this one of elderly ME/CFS patients (66 to 99 years old) which found no increased incidence of cancer in ME/CFS (in fact a slightly reduced rate of cancer), apart from a slightly increased risk of non-Hodgkin lymphoma.
 

skipskip30

Senior Member
Messages
237
Having seen the kind of science kings college have done in the past im afraid i have very little confidence in their results for any accurate comparison.
 

manna

Senior Member
Messages
392
Consistent with this chronic inflammatory context, CFS patients are known to have a shortened life-span and are at risk for developing lymphoma

from: http://www.prohealth.com/library/showarticle.cfm?libid=14948

Not sure where they get this data from. Cancer and suicide is what I've heard of most in connection to ME/CFS and MCS. That's just from years of forumming. Not sure if the above conclusion is from data or someone's many years personal experience of dealing with folk with the illness. This has been posted previously on PR from search results. Either or, it seems about right to me. The suicide stat is pertinent but I can't see it being the whole picture. I'm sure someone posted something on this on the FF forum but it's glitching with the searches at the mo. 25 years is what I recall too but am unsure of the validity
 
Messages
13,774
The study did a bit more that just find ME/CFS patients were "more" prone to committing suicide. They quantified the suicide rate (as being 6.85 times higher than normal). That then makes it possible to compare to other diseases, like multiple sclerosis, where one study found the suicide rate is 2 times higher than normal, or schizophrenia, where the suicide rate is around 60 times higher than normal. 1

As they said in their paper, two fewer suicides and there would have been no significant increase in risk. I don't think that we can have too much confidence that a suicide rate 6.85 times higher than normal would hold up in a larger study. They give a 95% confidence interval of 2·22–15·98.
 

Hip

Senior Member
Messages
17,824
@Esther12
I am sure you know that science often works like that: smaller scale studies come first, finding something statistically significant, and then wait for larger studies to replicate or refute the findings.

This study is nearly twice the size of the original US study, which looked at 1201 ME/CFS patients over a period of up to 14 years, and found a suicide rate of 8 times higher.

If a statistician were to pool the data from these two studies, it would increase the confidence in the results.
 

Dolphin

Senior Member
Messages
17,567
It also closely concurs with a previous US study on ME/CFS suicide prevalence, which found the suicide rate was 8 times the national average.
That's not what the study found:
All-cause mortality in chronically fatigued patients was no higher than expected, but suicide-caused death rates were more than eight times higher than in the US general population. The significant elevation in the SMR of suicide was restricted to those who did not meet criteria for CFS [SMR(CF)=14.2, 95% confidence interval (CI) 5.7-29.3 versus SMR(CFS)=3.6, 95% CI 0.4-12.9].
i.e. there was not statistically significant increase in suicide among those who satisfied CFS criteria
 

Hip

Senior Member
Messages
17,824
i.e. there was not statistically significant increase in suicide among those who satisfied CFS criteria

You are right, I must have misread that US study. I guess I should read things more carefully.

So in fact they found an eightfold increase in suicides in the chronically fatigued, but no increase in suicides in CFS patients.
 

Dolphin

Senior Member
Messages
17,567
You are right, I must have misread that US study. I guess I should read things more carefully.

So in fact they found an eightfold increase in suicides in the chronically fatigued, but no increase in suicides in CFS patients.
Well, suicide rates were 3.6 times higher, but the difference was not statistically significant.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
After controlling for age and other factors, the rate of deaths by suicide in this study was approximately six times higher in people with chronic fatigue syndrome than in the general population.
A finding similar to this was made in Australia, though I think unpublished in a medical journal. It was found that one in ten CFS patients had attempted suicide, and this was only the patients that admitted to it. There is no surety it was not higher. This figure jumped to one in six for long term patients. I have no further details aside from the source which was I think from the Victorian ME/CFS society at the time, which I think now calls itself the national society.

However given the high prevalence of misdiagnosis we cannot be sure that many of these patients did not have depression, or were not on medications with risk of suicide. There are probably many paths leading to suicide, from despair, social ostracizing/distrust/hate, inadequate support measures , inappropriate medication, inept medical care and so on. Suicide incidence is useful data, but only as ground to run a much better study.

From Lenny Jason's study there is indication that suicide in CFS makes major depression look like a minor issue. There are issues here about generalization and reporting standards though. Its very murky.

Once again we find reason to fund and run a very large very carefully conducted longitudinal or epidemiological study.