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The role of anxiety & depression in fatigue & patterns of pain among subgroups of fibromyalgia (FM) patients

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By Kurtze N, Gundersen KT, Svebak S • www.ProHealth.com • June 5, 1998


This study explored the relationship of anxiety and depression
with two major symptoms of fibromyalgia, pain and fatigue,
among fibromyalgia patients (N = 322). Due to collinearity
between anxiety and depression scores, extreme groups were
defined according to high versus low anxiety and depression
scores. Two-thirds of the initial sample were excluded by this
approach, which permitted a two by two factorial split- plot
ANOVA for the assessment of main effects and the interaction
of anxiety and depression upon pain and fatigue. Results
stated independent, additive, effects of anxiety and
depression upon levels of pain and fatigue, whereas
interaction between anxiety and depression failed to
significantly explain symptom differences among the
participants. Correlational analyses indicated widespread pain
among the low anxiety subgroups. In contrast, widespread pain
was not indicated among anxious patients with low scores on
depression. The findings support the hypothesis that (1)
anxiety and depression are independently associated with
severity of pain symptoms in fibromyalgia, and that (2)
patients with high anxiety and low depression may communicate
to the medical doctor in ways that involve a risk of
diagnosing fibromyalgia when the criterion of widespread pain
is not supported. These conclusions were confirmed by results
from ANCOVAs that permitted more extensive control of
collinearity among variables.




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