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Unraveling pathways to depression in fibromyalgia, the role of perseverative negative thinking and negative affect

Published online by Cambridge University Press:  23 March 2020

A.M. Pinto ,
C. Costa ,
A.T. Pereira ,
M. Marques ,
J.A. Pereira da Silva  and
A. Macedo
A.M. Pinto*
Affiliation:
Faculty of Psychology and Educational Sciences of the University of Coimbra, Cognitive and Behavioural Center for Research and Intervention, Coimbra, Portugal Faculty of Medicine of the University of Coimbra and Coimbra Hospital and University Centre, Rheumatology University Clinic, Coimbra, Portugal Faculty of Medicine of the University of Coimbra, Psychological Medicine Department, Coimbra, Portugal
C. Costa
Affiliation:
Faculty of Medicine of the University of Coimbra and Coimbra Hospital and University Centre, Rheumatology University Clinic, Coimbra, Portugal
A.T. Pereira
Affiliation:
Faculty of Medicine of the University of Coimbra, Psychological Medicine Department, Coimbra, Portugal
M. Marques
Affiliation:
Faculty of Medicine of the University of Coimbra, Psychological Medicine Department, Coimbra, Portugal Coimbra Hospital and University Centre, Department of Psychiatry, Coimbra, Portugal
J.A. Pereira da Silva
Affiliation:
Faculty of Medicine of the University of Coimbra and Coimbra Hospital and University Centre, Rheumatology University Clinic, Coimbra, Portugal
A. Macedo
Affiliation:
Faculty of Medicine of the University of Coimbra, Psychological Medicine Department, Coimbra, Portugal Coimbra Hospital and University Centre, Department of Psychiatry, Coimbra, Portugal
*
*Corresponding author.

Abstract

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Introduction

Several studies have demonstrated a strong link between fibromyalgia, negative affect (NA) and depression. However, it remains unclear why some fibromyalgia patients get depressed while others do not and, primarily, which mechanisms account for this difference. We hypothesize that, besides clinical features, the engagement in dysfunctional strategies like perseverative negative thinking (PNT) followed by an amplification of NA levels may increase the risk of fibromyalgia patients experiencing depressive symptoms.

Objective/Aims

To explore the serial mediator effect of PNT and NA on the relationship between fibromyalgia symptoms and depressive symptoms.

Methods

Hundred and three women with fibromyalgia (mean age 47.32 ± 10.63) completed the Portuguese version of the Revised-Fibromyalgia Impact Questionnaire, Perseverative Thinking Questionnaire, Profile of Mood States and Beck Depression Inventory-II. The association between the variables was investigated via Pearson correlations and serial multiple mediation.

Results

The estimated model was significant [F (3.86) = 57.318, P < .001] explaining 66.66% of depressive symptoms variance. The total effect of fibromyalgia symptoms on depressive symptoms was of .4998 (SE = 0.0795, P < 0.001; CI > 0.3417 and < 0.6578), with a significant direct effect of 0.1911 (SE = 0.0653; CI > 0.0614 and < 0.3209). The total indirect effects were of 0.3086 (SE = 0.0619; CI > 0.2033 < 0.4458). Three significant specific indirect effects were found.

Conclusion

The effect of fibromyalgia symptoms on depressive symptoms is partially operated through cognitive interference/unproductiveness, which in turn influences NA levels. Such findings highlight the crucial role of these constructs in the relationship between fibromyalgia symptoms and depressive symptoms and the urge to address them when treating individuals reporting greater fibromyalgia symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW378
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S207
Copyright
Copyright © European Psychiatric Association 2016
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