Relating psychological symptoms of depression and anxiety to pain sensitivity in patients with fibromyalgia: An exploration of the multifaceted nature of pain perception

Introduction: Fibromyalgia is a condition characterized by chronic widespread musculoskeletal pain and an increased pain sensitivity. Relating psychological symptoms of depression and anxiety to pain sensitivity measures could potentially increase our understanding of the multifaceted nature of pain perception. In this study the specific relationship between depression and the pressure pain threshold (PPT) was investigated, as well as the network of associations between depression, anxiety, PPT, temporal summation (TS), and aftersensation (AS). Methods: Fifteen female participants were included in this cross-sectional study. Depression and anxiety were measured with the HADS questionnaire and baseline measures of the PPT, TS, and AS were collected on thumb and tibia muscle locations. The PPT was assessed by applying pressure with an algometer until it became painful; TS was assessed by applying 10 pain stimuli in a row at the PPT level; AS included a pain score 15 seconds after the...Show moreIntroduction: Fibromyalgia is a condition characterized by chronic widespread musculoskeletal pain and an increased pain sensitivity. Relating psychological symptoms of depression and anxiety to pain sensitivity measures could potentially increase our understanding of the multifaceted nature of pain perception. In this study the specific relationship between depression and the pressure pain threshold (PPT) was investigated, as well as the network of associations between depression, anxiety, PPT, temporal summation (TS), and aftersensation (AS). Methods: Fifteen female participants were included in this cross-sectional study. Depression and anxiety were measured with the HADS questionnaire and baseline measures of the PPT, TS, and AS were collected on thumb and tibia muscle locations. The PPT was assessed by applying pressure with an algometer until it became painful; TS was assessed by applying 10 pain stimuli in a row at the PPT level; AS included a pain score 15 seconds after the tenth pain stimulation and a ratio for its relative size. Correlation analysis was performed both on the data of the thumb and tibia muscle, as well as on pooled data. Results: Correlation analysis found no significant correlations between depression and the PPT (rs(13) = .312, p = .257; rs(13) = .047, p = .867; rs(28) = .063, p = .741). Significant correlations were found for depression and anxiety (rs (13) = .800, p < .001; rs(28) = .800, p < .001), PPT and AS (rs(13) = .531, p = .041; rs(13) = .745, p = .001; rs(28) = .442, p = .014), PPT (l) and AS ratio (a) (rs(13) = .525, p = .044), depression and AS ratio (rs(28) = -.361, p = .050), for all correlations between AS and AS ratio, and for all correlations between the thumb and tibia muscle location of each variable (e.g., PPT (a) and PPT (l)). All other relationships were non-significant. Conclusion: Forming solid conclusions remains difficult due to research limitations and explorative analysis. This study does symbolize an innovative scientific step towards using a network approach for looking at a complex condition like fibromyalgia, with the aim to create a more integrative understanding.Show less

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Relating psychological symptoms of depression and anxiety to pain sensitivity in patients with fibromyalgia: An exploration of the multifaceted nature of pain perception