title: Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia.
abstract: OBJECTIVE
  This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM.
  
  
  METHODS
  A total of 451 women with FM participated in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM severity (revised Fibromyalgia Impact Questionnaire), and HRQoL (SF-36) were assessed.
  
  
  RESULTS
  Participants with severe depressive symptoms had significantly higher pain intensity (NRS = 1.1; 95 % CI 0.3-1.8), fatigue (12.6-units; 95 % CI 8.2-17.1) and overall FM severity (12.6-units; 95 % CI 11.4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQoL (P > 0.05).
  
  
  CONCLUSIONS
  These results extend current knowledge on the association of signs of depression with FM severity and quality of life in women with FM, and suggest that severity of depressive symptoms could potentially be a prognostic factor to be considered in future prospective intervention studies.
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain. asm@ugr.es.
authors.forename: Alberto
authors.identifier: http://orcid.org/0000-0002-4626-420X
authors.initials: A
authors.lastname: Soriano-Maldonado
authors.affiliation: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Kirstine
authors.initials: K
authors.lastname: Amris
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Segura-Jiménez
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.|Department of Clinical and Health Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Fernando
authors.initials: F
authors.lastname: Estévez-López
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.
authors.forename: Inmaculada C
authors.initials: IC
authors.lastname: Álvarez-Gallardo
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.|Department of Physiology, Faculty of Pharmacy, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain.|Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Aparicio
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Delgado-Fernández
authors.affiliation: Department of Rheumatology, The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark.
authors.forename: Marius
authors.initials: M
authors.lastname: Henriksen
authors.affiliation: Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Avda. de Alfacar s/n. 18011, Granada, Spain.
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: Chronic pain; Depression; Fatigue; Health-related quality of life; Mental health; Physical function