Somatic symptom presentations in women with fibromyalgia are differentially associated with elevated depression and anxiety

Hadlandsmyth, Katherine; Dailey, Dana L; Rakel, Barbara A; Zimmerman, M Bridget; Vance, Carol GT; Merriwether, Ericka N; Chimenti, Ruth L; Geasland, Katharine M; Crofford, Leslie J; Sluka, Kathleen A

doi:10.1177/1359105317736577

Cited by 48Fibromyalgia and Chronic Fatigue Syndrome ResearchPsychosomatic Disorders and Their TreatmentsMusculoskeletal pain and rehabilitation

Somatic symptom presentations in women with fibromyalgia are differentially associated with elevated depression and anxiety

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Hadlandsmyth, Katherine, Dailey, Dana L, Rakel, Barbara A, Zimmerman, M Bridget, Vance, Carol GT, Merriwether, Ericka N, Chimenti, Ruth L, Geasland, Katharine M +2 more·2020·Journal of Health Psychology

DOI 10.1177/1359105317736577PMC PMC6287969

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Abstract

This study examined whether depression and anxiety differentially relate to fatigue, sleep disturbance, pain catastrophizing, fear of movement, and pain severity in women with fibromyalgia. Baseline data from the Fibromyalgia Activity Study with Transcutaneous Electrical Nerve Stimulation were analyzed. Of 191 participants, 50 percent reported high anxiety and/or depression (17% high anxiety, 9% high depression, and 24% both). Fatigue and sleep impairment were associated with high depression ( p < 0.05). Pain severity, pain catastrophizing, and fear of movement were associated with high anxiety and high depression ( p < 0.05). Possible implications for underlying mechanisms and the need for targeted treatments are discussed.

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Understanding the underlying disease process will provide insights for targeted therapeutic approaches.
“Understanding the underlying disease process will provide insights for targeted therapeutic approaches.7,10”
From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [10]
The Introduction says that identifying fibromyalgia patient subgroups and understanding relationships between symptoms and psychological distress can inform targeted interventions. The Discussion likewise suggests tailored treatments, but the paper does not establish that understanding the underlying disease process—as distinct from symptom patterns—will provide those insights. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Fibromyalgia is a disabling chronic pain syndrome characterized by multiple symptoms, including medically unexplained widespread pain, fatigue, cognitive, mood and sleep disorders.
“Fibromyalgia (FM) is a disabling chronic pain syndrome characterized by multiple symptoms, including medically unexplained widespread pain, fatigue, cognitive, mood and sleep disorders.1–11”
From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [10]
The Introduction (page unavailable) describes fibromyalgia as a chronic pain condition that can be disabling and is associated with fatigue, sleep disturbance, cognitive difficulties, and psychological distress. It also discusses depression and anxiety in people with fibromyalgia. Our copy does not characterize the pain as medically unexplained or explicitly describe it as widespread. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Severe fatigue impacts depression, pain perception, physical functioning, and exercise adherence in fibromyalgia.
“More than 80% of people with FM experience poor sleep quality with severe fatigue impacting depression,3 pain perception, physical functioning10 and exercise adherence.2,17,21”
From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [10]
The Results (Fatigue) report that women with fibromyalgia in the high-depression group had significantly higher fatigue scores. This supports an association, but not the claim that fatigue impacts or causes depression. In the citing sentence, this source is attached to depression; the other outcomes have separate citations. (LLM, conf=0.87)
Experimental — accuracy not yet measured
More than 80% of people with fibromyalgia experience poor sleep quality with severe fatigue.
“More than 80% of people with FM experience poor sleep quality with severe fatigue impacting depression,3 pain perception, physical functioning10 and exercise adherence.2,17,21”
From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [10]
The Introduction (page unavailable) says pain, fatigue, and impaired sleep are reported in nearly all people with fibromyalgia, which broadly supports the prevalence claim. The Results and Discussion (pages unavailable) link sleep disturbance and fatigue with depression, but the paper does not establish that more than 80% experience the specific combination of poor sleep quality and severe fatigue, or that these symptoms cause depression. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Psychological factors contribute to decreased movement in patients with chronic musculoskeletal pain.
“The influence of psychological factors is already well described in patients with chronic musculoskeletal pain contributing to decreased movement.10,29”
From A Review of Movement and Functional Impairments in Fibromyalgia: Implications for Targeted Treatment (2025) · cites this paper as [10]
The Introduction (page not available in our copy) says that pain catastrophizing and fear of movement are associated with pain-related disability in people with fibromyalgia, and that pain-specific distress can affect function. It does not establish that psychological factors cause decreased movement, or extend that finding to patients with chronic musculoskeletal pain generally. (LLM, conf=0.85)
Experimental — accuracy not yet measured

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Authors: Hadlandsmyth, K., Dailey, D. L., Rakel, B. A., Zimmerman, M. B., Vance, C. G., Merriwether, E. N., Chimenti, R. L., Geasland, K. M., Crofford, L. J., & Sluka, K. A.
Affiliations: University of Iowa (US)
Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, USA
Vanderbilt University (US)
Corresponding author: Hadlandsmyth, Katherine
ORCID: Hadlandsmyth, Katherine
Dailey, Dana L
Rakel, Barbara A
Merriwether, Ericka N
Chimenti, Ruth L
Geasland, Katharine M
Crofford, Leslie J
Sluka, Kathleen A
Venue: Journal of Health Psychology
Publisher: SAGE Publications
Published: 2017-10-27
Volume: 25
Issue: 6
Pages: 819-829
ISSN: 1359-1053 (ISSN-L)
1461-7277
DOI: 10.1177/1359105317736577
PMC: PMC6287969
OpenAlex: W2766034560
Cited by: 48
References: 62
Citations by year: 2026: 5 · 2025: 11 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 3 · 2020: 9 · 2019: 1 · 2018: 3
FWCI: 2.92
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Health Psychology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (54TR001013, U54TR001356, UM1 AR06338, UM1 AR06338-S1)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: fibromyalgia, somatic symptoms, depression, anxiety, fatigue, sleep disorders, pain catastrophizing, kinesiophobia, pain intensity, women, transcutaneous electrical nerve stimulation
MeSH terms: Medically Unexplained Symptoms, Adult, Anxiety, Depression, Fatigue, Female, Fibromyalgia, Humans, Middle Aged, Sleep Wake Disorders, Comorbidity, Young Adult, Catastrophization

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Somatic symptom presentations in women with fibromyalgia are differentially associated with elevated depression and anxiety

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