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Mortality in a cohort of chronically fatigued patients

Published online by Cambridge University Press:  08 August 2006

WAYNE R. SMITH ,
CAROLYN NOONAN  and
DEDRA BUCHWALD
WAYNE R. SMITH
Affiliation:
Departments of Psychiatry and Behavioral Sciences and Medicine, University of Washington, Seattle, WA, USA
CAROLYN NOONAN
Affiliation:
Departments of Psychiatry and Behavioral Sciences and Medicine, University of Washington, Seattle, WA, USA
DEDRA BUCHWALD
Affiliation:
Departments of Psychiatry and Behavioral Sciences and Medicine, University of Washington, Seattle, WA, USA
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Abstract

Background. Comprehensive studies of mortality among patients with chronic fatigue (CF) and chronic fatigue syndrome (CFS) have not been published, but several sources suggest that CFS is associated with an elevated risk for suicide.

Method. Data on 1201 chronically fatigued patients followed in a university-affiliated tertiary-care clinic for up to 14 years were submitted to the Center for Disease Control and Prevention (CDC) National Death Index (NDI) to evaluate all-cause and suicide-caused death rates against standardized mortality rates (SMRs). We used Life Table Analysis to examine the influence of sex and diagnoses of CFS and depression.

Results. 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 [SMRCF=14·2, 95% confidence interval (CI) 5·7–29·3 versus SMRCFS=3·6, 95% CI 0·4–12·9]. Among chronically fatigued patients who did not meet CFS criteria, those with a lifetime history of major depression (MD) had higher suicide-caused death rates than among their non-depressed counterparts (SMRMD=19·1, 95% CI 7·0–41·5 versus SMRNMD=5·6, 95% CI 0·1–31·4), although the difference was not significant.

Conclusions. CFS does not appear to be associated with increased all-cause mortality or suicide rates. Clinicians, however, should carefully evaluate patients with CF for depression and suicidality.

Type
Original Article
Information
Psychological Medicine , Volume 36 , Issue 9 , September 2006 , pp. 1301 - 1306
Copyright
2006 Cambridge University Press

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