The Mediating Role of Depression and Pain Catastrophizing in the Relationship between Functional Capacity and Pain Intensity in Patients with Fibromyalgia

Abstract

Background. Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition characterized by widespread pain, sleep problems (i.e., insomnia and unrefreshing sleep), fatigue, cognitive, and emotional difficulties. Although pain has been proposed the factor mostly impacting in the FMS patients’ function, emotional and psychological FMS-associated factors are also known to exert a negative impact in quality of life and functional capacity. Nonetheless, the relationship between these factors and functional limitations in FMS patients is considered to be complex and not clearly defined. Therefore, the present study is aimed at assessing the associations between FMS functional capacity, FMS symptoms (pain, fatigue, insomnia, depression, and state and trait anxiety), and associated psychological factors such as pain catastrophizing, as well as the possible mediating role of these latter in the relationship between pain and FMS functional capacity. Method. 115 women diagnoses with FMS completed a set of self-administered questionnaires to evaluate the clinical and psychological variables of the study. Results. FMS functional capacity was positively associated with the majority of FMS symptoms except state anxiety. Regression analyses confirmed a greater prediction for FMS functional capacity by depression, fatigue, and pain catastrophizing, in this sequence. Both, pain catastrophizing and depression were important factors mediating the association between clinical pain (total and intensity) and FMS functional capacity. Conclusions. Findings support a key role of pain catastrophizing and depression in the disability associated to pain in FMS. Treatment goals directed to lessen depression and pain catastrophizing levels should be promoted to reduce the impact of pain in FMS patients’ daily function.

Perfil epidemiológico e qualidade de vida dos pacientes com fibromialgia nos serviços de Reumatologia em Aracaju-SE

“…Além disso, entre os sintomas clínicos da FM, a fadiga tem sido considerada um dos mais preocupantes, afetando o impacto funcional da doença, produzindo até mesmo comportamentos sedentários intensos ao limitar a capacidade de realizar rotinas diárias. (Montoro, et al 2022). Primeiro, e como esperado, uma discrepância muito grande foi encontrada entre os grupos FM e Saudável com relação às medidas relacionadas à depressão, ansiedade e qualidade do sono.…”

Intervenciones psicológicas para el tratamiento de la fibromialgia: una revisión narrativa

“…Asimismo, el carácter estresante de la enfermedad contribuye a la aparición de síntomas de ansiedad, depresión y enfado hacia uno mismo en esta población (Amutio et al, 2015). Todas estas emociones negativas pueden aumentar o amplificar el dolor y, por tanto, la forma en que las personas con fibromialgia procesan y regulan sus emociones puede ser relevante para la adaptación al dolor (Montoro & Galvez-Sánchez, 2022). Ante todo lo expuesto, la presente revisión pretende dar a conocer los principales tratamientos psicológicos para abordar la sintomatología emocional de estos pacientes.…”

Minocycline abrogates individual differences in nerve injury-evoked affective disturbances in male rats and prevents associated supraspinal neuroinflammation

“…There is therefore great interest in uncovering the reasons for individual differences in disability in response to nerve injury (Chou and Shekelle 2010;Tanguay-Sabourin et al 2023). Increased evoked nociceptive hypersensitivity does not fully explain these individual differences (Bagnato et al 2015;Montoro and Galvez-Sánchez 2022), and instead psychosocial factors such as coping style, pain catastrophising, and self-efficacy appear to mediate increased selfreported pain intensity levels in chronic pain patients with high levels of disability (Arnstein et al 1999;Pincus et al 2002;Wood et al 2016;Lazaridou et al 2022). Depression and anxiety are common disabling comorbidities, affecting between one and two-thirds of chronic pain patients, though there is again individual variation in their incidence and severity mediated by emotional coping style and other factors (Cherif et al 2020;Kec et al 2022;Damci et al 2022).…”