Fibromyalgia & musculoskeletal pain
Alleviation of depression rather than pain predicts disease improvement in fibromyalgia patients with prominent psychological symptoms–a prospective observational study
Authors' conclusion
Psychological symptoms, as much as pain, vitally determined disease severity in FM. For FM-AD individuals, alleviation of depression, rather than pain relief alone, pivotally predicted disease improvement.
Study context
- Population
- Newly diagnosed fibromyalgia (FM) patients treated with pregabalin with/without imipramine; healthy controls also recruited
- Participants
- 112 newly diagnosed FM cases
- Exposure
- FM with prominent anxiety and depression symptoms vs FM without
- Outcome
- Determinants of clinical improvement in FM-AD (linear mixed-effect regression and mediation)
- Follow-up
- 4 weeks
Methodological detailscluster, correlation, regression and mediation analyses, 4-week follow-up, no placebo control
- Cluster, correlation, regression and mediation analyses
- 4-week follow-up
- No placebo control
Main finding
As reported in the abstract
- Depression remission determined clinical improvement in FM-AD
- p = 0.039
- Pain reduction did not determine clinical improvement in FM-AD
- p = 0.062
- Direct effect of depression remission on disease improvement in FM-AD
- p = 0.003
- Indirect effect via pain reduction
- p = 0.101
Observational data: associations, not effects.
Further findings
Phenotype: pain, disease severity and therapeutic response
- FM-AD had more intense pain, worse disease severity and poorer therapeutic responses than FM-nAD
- all p < 0.001
Correlates of disease severity
- Along with pain, depression and anxiety symptoms modulated disease severity
- all p < 0.001
Original publication
Alleviation of depression rather than pain predicts disease improvement in fibromyalgia patients with prominent psychological symptoms–a prospective observational study. Semin Arthritis Rheum. Published 11 January 2026. doi:10.
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