The Mediating Role of Pain-Related Disability in the Relationship Between Biological Rhythms and the Severity of Depressive Symptoms in Fibromyalgia.

IF 2 3区医学 Q3 CLINICAL NEUROLOGY

Behavioral Sleep Medicine Pub Date : 2026-07-01 Epub Date: 2026-03-31 DOI:10.1080/15402002.2026.2648511

Roman Orzechowski, Guilherme Rodriguez Amando, Bárbara Regina França, Betina Franceschini Tocchetto, Luísa Klaus Pilz, Arthur França de Souza, Vania Naomi Hirakata, Felipe Fregni, Maria Paz Hidalgo, Wolnei Caumo

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引用次数: 0

Abstract

Objective: To estimate the role of disability mainly in the link between chronobiological factors (sleep, light exposure, and rest/activity patterns) and depressive symptoms in people with fibromyalgia (FM).

Methods: A cross-sectional study was conducted on a cohort of 197 women, aged 18-65, diagnosed with FM. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI), while FM-related disability was assessed through the Fibromyalgia Impact Questionnaire (FIQ). Actigraphy data (activity and light exposure) over 10 consecutive days and sleep-related behaviors were assessed. Mediation models were performed to investigate the direct and indirect (through FIQ) effects of chronobiological parameters on depressive symptoms.

Results: A negative Direct Effect (DE) was identified between BDI scores and light interdaily stability (DE = -4.89), as well as sleep duration on free days (DE = -0.81). There were also Indirect Effects (IE) through FIQ of both intradaily variability of activity rhythms (IE = 3.02) and sleep duration on workdays (IE = -0.47) on BDI scores.

Conclusion: Our findings offer evidence that disability due to fibromyalgia symptoms mediates the relationship between rhythm fragmentation and severity of depressive symptoms, providing insights for improved care and therapeutic interventions in fibromyalgia.

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疼痛相关失能在生物节律与纤维肌痛抑郁症状严重程度关系中的中介作用。

目的：评估残疾主要在时间生物学因素（睡眠、光照和休息/活动模式）与纤维肌痛（FM）患者抑郁症状之间的联系中的作用。方法：对197名年龄18-65岁确诊为FM的女性进行横断面研究。使用贝克抑郁量表- ii （BDI）测量抑郁症状，而通过纤维肌痛影响问卷（FIQ）评估fm相关残疾。对连续10天的活动记录仪数据（活动和光照）和睡眠相关行为进行评估。采用中介模型来研究时间生物学参数对抑郁症状的直接和间接（通过FIQ）影响。结果：BDI评分与日间光照稳定性（DE = -4.89）以及自由日睡眠时间（DE = -0.81）之间存在负直接效应（DE）。通过FIQ，还存在活动节律（IE = 3.02）和工作日睡眠时间（IE = -0.47）对BDI评分的间接影响（IE）。结论：我们的研究结果提供了证据，表明纤维肌痛症状导致的残疾介导了节律碎片化和抑郁症状严重程度之间的关系，为改善纤维肌痛的护理和治疗干预提供了见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Behavioral Sleep Medicine CLINICAL NEUROLOGY-PSYCHIATRY

CiteScore

7.20

自引率

3.20%

发文量

审稿时长

>12 weeks

期刊介绍： Behavioral Sleep Medicine addresses behavioral dimensions of normal and abnormal sleep mechanisms and the prevention, assessment, and treatment of sleep disorders and associated behavioral and emotional problems. Standards for interventions acceptable to this journal are guided by established principles of behavior change. Intending to serve as the intellectual home for the application of behavioral/cognitive science to the study of normal and disordered sleep, the journal paints a broad stroke across the behavioral sleep medicine landscape. Its content includes scholarly investigation of such areas as normal sleep experience, insomnia, the relation of daytime functioning to sleep, parasomnias, circadian rhythm disorders, treatment adherence, pediatrics, and geriatrics. Multidisciplinary approaches are particularly welcome. The journal’ domain encompasses human basic, applied, and clinical outcome research. Behavioral Sleep Medicine also embraces methodological diversity, spanning innovative case studies, quasi-experimentation, randomized trials, epidemiology, and critical reviews.