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01-07-2020 | Mental health | News

Heightened risk for self-harm with some rheumatic diseases

Author: Hannah Kitt

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medwireNews: Patients with rheumatic diseases, particularly fibromyalgia, have elevated rates of self-harm, according to data from the Clinical Practice Research Datalink.

James Prior, from Keele University in the UK, and fellow investigators assert that “healthcare professionals need to be aware of this risk and offer appropriate management,” particularly as they found that incidence rates have remained “relatively consistent” year-on-year from 2000 to 2016.

The team analyzed data pertaining to patients with osteoarthritis (OA; n=410,384), rheumatoid arthritis (RA; n=23,205), fibromyalgia (n=17,546), and ankylosing spondylitis (AS; n=10,484) over a period of 26 years (1990–2016).

Patients with fibromyalgia had the highest rate of self-harm, at 25.12 per 10,000 person–years, while those with OA had the lowest incidence, at 6.48 per 10,000 person–years. The rates among patients with AS or RA were 11.37 and 9.70 per 10,000 person–years, respectively.

This compared with incidence rates of between 4.13 and 9.57 per 10,000 person–years among similar numbers of matched individuals without each of the rheumatic conditions.

The researchers found that there was a significantly increased risk for self-harm associated with all conditions, except for AS.

After adjusting for multiple variables, including age, sex, practice-level deprivation, BMI, smoking status, alcohol consumption, anxiety, and depression, the risk for self-harm was increased a significant 2.06-fold among patients with fibromyalgia and 1.59-fold among those with RA.

The patients with OA were further stratified by disease duration, due to nonproportionality over time, and the risk for self-harm was increased a significant 1.12- and 1.35-fold for those with durations of 1–4 and 5–9 years, respectively. But there was no significant association with self-harm among those with durations of less than 1 year or 10 or more years.

Further analysis to determine the effects of age and gender on the risk for self-harm showed both to be “weak” effect modifiers, Prior et al report in Arthritis Care & Research.

Given the increased risk for self-harm among patients with rheumatologic conditions, the researchers highlight the need for “interventions to reduce this serious comorbidity,” and conclude that “clinicians should be vigilant, explore mood, assess risk, and offer appropriate support and management, especially to patients with fibromyalgia.”

medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group

Arthritis Care Res 2020; doi:10.1002/ACR.24345

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