Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Observed Findings

• • ME/CFS patients experience increased suicide risk compared to general population
• • Absence of disease-modifying treatments contributes to psychological burden and suicide risk
• • Severe functional limitations and symptom characteristics restrict availability of standard psychiatric/psychological therapies
• • Healthcare provider educational gaps about ME/CFS contribute to inadequate care and patient reluctance to engage with mental health services
• • Virtual and asynchronous mental health care modalities show promise for severely ill patients unable to attend in-person appointments

Inferred Conclusions

• • Outpatient medical professionals are well-positioned to assess and address suicidality in ME/CFS patients and should be trained in disease-specific risk and protective factors
• • Standard evidence-based suicide assessment and intervention protocols should be adapted to account for ME/CFS-specific challenges including post-exertional malaise, cognitive dysfunction, and symptom variability
• • Increased access to virtual and asynchronous psychiatric care can improve mental health support for patients with severe functional limitations
• • Healthcare provider education about ME/CFS etiology and pathophysiology is essential to reduce stigma and improve patient engagement with mental health care

Remaining Questions