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Pain catastrophizing mediates the negative influence of pain and trait-anxiety on health-related quality of life in fibromyalgia

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Abstract

Background

Patients with fibromyalgia syndrome (FMS) usually display a decrease in health-related quality of life (HRQoL). This decrease in HRQoL is related to clinical pain, anxiety, and depression. This cross-sectional study analyzes the mediating role of pain-coping strategies (especially catastrophizing) in the negative relationships of pain, anxiety, depression, and HRQoL in FMS.

Methods

One hundred and thirteen women with FMS and 63 healthy women were assessed using the Short-Form Health Survey (SF-36). Participants completed self-report questionnaires to evaluate clinical pain, anxiety, depression, and pain-coping strategies.

Results

Pain catastrophizing was inversely associated with the physical function, general health perception, vitality, emotional role, mental health, the physical and mental general components, and the global index of HRQoL, with percentages of variance explained ranging between 9 and 18%. Cognitive distraction showed a positive association with the physical function, general health perception, vitality, emotional role, mental health, physical component, and global index of HRQoL, with percentages of variance explained ranging between 4 and 7%. Mediation analysis showed that catastrophizing mediates the negative influence of clinical pain and trait-anxiety on the physical function, general health perception, vitality, mental health, and global index of HRQoL. No mediating effect of pain catastrophizing on the relation between depression and HRQoL was observed.

Conclusions

Patients with FMS exhibited markedly lower HRQoL than healthy individuals. While pain catastrophizing was inversely related to several domains of HRQL, associations were positive for cognitive distraction. Catastrophizing mediates the negative influence of clinical pain and trait-anxiety on HRQoL. Therefore, cognitive behavioral treatments focused on adaptive management and control of catastrophizing and negative emotional states may be helpful.

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Funding

This research was supported by a grant from the Spanish Ministry of Science and Innovation co-financed by FEDER funds (Project RTI2018-095830-B-I00) and a FPU pre-doctoral contract (ref: FPU2014-02808) from a grant from the Spanish Ministry of Education, Culture and Sport. The funding sources had no participate in the preparation of the article, the collection, analysis and interpretation of data; the writing of the article; nor in the decision to submit it for publication.

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CMGS conceived the original idea with GARP, contributed with the design of the experiments, carried out the experiment, analyzed the data and wrote the manuscript with support from GARP and SD. CIM contributed with the design of the experiments and analyzed the data. SD supervised the project, analyzed the data and contributed to the final version of the manuscript. GARP conceived the original idea with CMGS, designed the experiments, supervised the project, analyzed the data and contributed to the final version of the manuscript.

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Correspondence to Carmen M. Galvez-Sánchez.

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Galvez-Sánchez, C.M., Montoro, C.I., Duschek, S. et al. Pain catastrophizing mediates the negative influence of pain and trait-anxiety on health-related quality of life in fibromyalgia. Qual Life Res 29, 1871–1881 (2020). https://doi.org/10.1007/s11136-020-02457-x

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