title: Direct and Indirect Effects of Function in Associated Variables Such as Depression and Severity on Pain Intensity in Women with Carpal Tunnel Syndrome.
abstract: OBJECTIVE
  To determine the direct and indirect effects of function on clinical variables such as age, pain intensity, years of the disease, severity of symptoms, and depression in women with electrodiagnostic and clinical diagnosis of carpal tunnel syndrome (CTS).
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Patients from an urban hospital referred to a university clinic.
  
  
  METHODS
  Two hundred and forty-four (n = 224) women with CTS were included. Demographic and clinical data, duration of symptoms, function, symptom's severity of the symptoms, pain intensity, and depression were self-reported collected. Correlation and path analysis with maximum likelihood estimation were conducted to assess the direct and indirect effect of hand function on pain, age, years with the disease, symptoms severity, and depression.
  
  
  RESULTS
  Significant positive correlations between function and pain intensity, years with pain and symptoms severity were observed. The path analysis found direct effects from depression, symptoms severity, and years with pain to function (all, P < 0.01). Paths between function and depression on pain intensity (both, P < 0.01) were also observed. The amount of function explained by all predictors was 22%. The indirect effects in the path analysis revealed that function exerted an indirect effect from depression to pain intensity (B = 0.18; P < 0.01), and from symptoms severity to the intensity of pain (B = 0.10; P < 0.01). Overall, the amount of current pain intensity explained by all predictors in the model was R(2)  = 0.22.
  
  
  CONCLUSIONS
  Our study demonstrated that function mediates the relationship between depression and symptoms severity with pain intensity in women with CTS. Future longitudinal studies will help to determine the clinical implications of these findings.
authors.affiliation: Department Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, Alcorcón, Spain.|Grupo Excelencia Investigadora URJC-Banco Santander Referencia Nº30vcpigi03: Investigación Traslacional En El Proceso De salud - Enfermedad (ITPSE).
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-las-Peñas
authors.affiliation: Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Spain.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Fernández-Muñoz
authors.affiliation: Department Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, Alcorcón, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Palacios-Ceña
authors.affiliation: Departamento de Psicología Evolutiva y de La Educación, Universitat de Valencia, Valencia, Spain.
authors.forename: Esperanza
authors.initials: E
authors.lastname: Navarro-Pardo
authors.affiliation: Department Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, Alcorcón, Spain.|Grupo Excelencia Investigadora URJC-Banco Santander Referencia Nº30vcpigi03: Investigación Traslacional En El Proceso De salud - Enfermedad (ITPSE).
authors.forename: Silvia
authors.initials: S
authors.lastname: Ambite-Quesada
authors.affiliation: Department Physical Therapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, Alcorcón, Spain.|Grupo Excelencia Investigadora URJC-Banco Santander Referencia Nº30vcpigi03: Investigación Traslacional En El Proceso De salud - Enfermedad (ITPSE).
authors.forename: Jaime
authors.initials: J
authors.lastname: Salom-Moreno
mesh_terms: D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D010147:Pain Measurement; D015995:Prevalence; D020127:Recovery of Function; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D063189:Symptom Assessment; D016387:Women's Health / Q000706:statistics & numerical data
keywords: Carpal Tunnel Syndrome; Depression; Function; Mediation; Pain; Severity