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Y. Matsukawa, Suicides in persons suffering from rheumatoid arthritis, Rheumatology, Volume 42, Issue 12, December 2003, Pages 1571–1572, https://doi.org/10.1093/rheumatology/keg408
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Sir, I read with interest the detailed report by Timonen et al. [1] assessing suicides in patients with rheumatoid arthritis (RA). They studied suicides of RA patients using official death certificates based on forensic medico-legal investigation of Oulu, Finland and found 19 suicide victims to be RA patients. As a result, they concluded that the presence of depressive disorders and a history of at least one suicide attempt were risks for suicide completion. They also observed a unique phenomenon—half of suicidal patients with RA were women. This tendency is not in agreement with suicide cases in non-RA individuals: in general, men are at a higher risk than women. Of the 21 suicide victims, eight patients (female:male, 6:2) had been admitted to hospital owing to psychiatric problems prior to suicide completion. Because patients with systemic lupus erythematosus (SLE) have a relatively high risk for suicide [2–4] and because women are at a higher risk of developing SLE, some of the six RA patients who committed suicide might have had concurrent SLE. In addition, I would like the order of the onset time of the two diseases to be confirmed, i.e. did RA precede psychiatric disease or did psychiatric disease precede RA. When patients with psychiatric disease develop RA and subsequently attempt suicide, it is reasonable to assume that such suicides are related to psychiatric disease. Therefore, I would be very grateful if information on the presence of co-morbid rheumatic diseases and the onset time of both RA and psychiatric disease could be provided. They would be very helpful in understanding the mechanism that induces suicide in patients with rheumatic diseases such as RA and SLE.
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