PURPOSE Fibromyalgia (FM) is typically associated with the experience of diffuse pain and physical impairment. Depression also commonly co-exists in patients with FM, and has been correlated with pain intensity and physical functioning. Previous research suggests an association between pain intensity and physical functioning; however, the direct causal relationship between improvements in pain intensity and in functioning is not observed in many FM patients. This may suggest that another factor such as depression is mediating this relationship. The present work examined mediating role of depression. METHODS 216 patients with FM completed measures of pain intensity, depression, and physical function as part of a larger longitudinal study. Assessments were completed at baseline, 12, 24, and 36 weeks. RESULTS Longitudinal mediational analyses indicated that depression is a partial mediator of the relationship between pain intensity and physical functioning at all four assessment points. Beta coefficients for the path from pain to physical functioning ranged from 0.18 - 0.36, with attenuated path coefficients ranging from 0.03 - 0.08, still showing significant but decreased associations when depression was added as a mediator. CONCLUSIONS Clinical implication includes the importance of treating co-morbid depression in patients with fibromyalgia early in the course of treatment to prevent engagement in the cycle of disability.

中文翻译：

---

纤维肌痛的疼痛强度与身体机能之间的复杂关系：抑郁的中介作用。

目的纤维肌痛（FM）通常与弥漫性疼痛和身体障碍的经历有关。FM患者通常还伴有抑郁症，并且与疼痛强度和身体功能相关。先前的研究表明疼痛强度与身体机能之间存在关联。但是，在许多FM患者中，并未观察到疼痛强度和功能改善之间的直接因果关系。这可能表明诸如抑郁之类的另一因素正在介导这种关系。本工作探讨了抑郁症的中介作用。方法216例FM患者完成了一项较大的纵向研究，完成了对疼痛强度，抑郁和身体机能的测量。在基线，第12、24和36周完成评估。结果纵向中介分析表明，在所有四个评估点，抑郁是疼痛强度与身体机能之间关系的部分中介。从疼痛到身体功能的路径的Beta系数在0.18-0.36之间，衰减的路径系数在0.03-0.08之间，当添加抑郁症作为介体时，仍显示出显着但下降的关联。结论临床意义包括在治疗过程中及早治疗纤维肌痛患者的合并症抑郁的重要性，以防止其参与残疾循环。18-0.36，衰减路径系数在0.03-0.08范围内，当添加抑郁症作为介体时，仍显示出显着但下降的关联。结论临床意义包括在治疗过程中及早治疗纤维肌痛患者的合并症抑郁的重要性，以防止其参与残疾循环。18-0.36，衰减路径系数在0.03-0.08范围内，当添加抑郁症作为介体时，仍显示出显着但下降的关联。结论临床意义包括在治疗过程中及早治疗纤维肌痛患者的合并症抑郁的重要性，以防止其参与残疾循环。