ArticleHealth psychology and behavioral medicine2022
The role of pain and psychological distress in fatigue: a co-twin and within-person analysis of confounding and causal relations.
Article in Health psychology and behavioral medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Patient Experiences and Preliminary Effects of Virtual Reality Based Pain Treatment in Rheumatoid Arthritis Patients With Persistent Pain Despite Low Disease Activity: A Mixed Method Pilot Study.Musculoskeletal care · 2026Article
- The Handgrip Endurance Task as a Simple Clinical Indicator of Mental Fatigue in Patients with Chronic Low Back Pain.Journal of pain research · 2026Article
- Recovery indicators from the perspective of patients with chronic low back pain: a cross-sectional survey.Pain management · 2025Article
- Fatigue in intensive care unit survivors with COVID-19: An observational cohort study.Brain, behavior, & immunity - health · 2025Article
- Associations between pain intensity, psychosocial factors, and pain-related disability in 4285 patients with chronic pain.Scientific reports · 2024Article
- Article
- Health-Related Quality of Life in FKRP-Related Limb-Girdle Muscular Dystrophy R9.Journal of neuromuscular diseases · 2024Article
- Pain interference and fatigue in limb-girdle muscular dystrophy R9.Neuromuscular disorders : NMD · 2023Article
- Is the Pandemic Wearing Us Out? A Cross-Sectional Study of the Prevalence of Fatigue in Adult Twins without Previous SARS-CoV-2 Infection.Journal of clinical medicine · 2022Article
- Pain and fatigue in adults with Loeys-Dietz syndrome and vascular Ehlers-Danlos syndrome, a questionnaire-based study.American journal of medical genetics. Part A · 2022Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFatigue is a common symptom in somatic and mental illness. Musculoskeletal pain and psychological distress have in turn frequently been shown to be associated with fatigue across clinical conditions and in the general population. The study aims to disentangle direct effects from those due to mere confounding from shared etiologies.
designThe study used genetically informative longitudinal twin data, through a co-twin control design with an additional within-person dimension.
methodsData on fatigue, pain and distress from 2196 mono - and dizygotic twins from the Norwegian Twin Registry examined at two time points five years apart was analyzed using multilevel generalized linear regression modeling. Fatigue was regressed on pain and distress, with further controls added for confounding from genetic and stable non-shared environmental sources.
resultsPain and distress had a significant impact on fatigue at genetic, stable non-shared environmental and time-varying levels, even when controlling for somatic comorbidity.
conclusionThe findings indicate that a significant proportion of the association between fatigue, pain and distress is due to genetic and environmental confounding. Pain and distress exert significant, albeit smaller effects on fatigue even when controlling for genetic and stable environmental contributions, indicating direct effects. Potential etiological pathways and underlying mechanisms are discussed.
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