RESUMO
BACKGROUND: Chronic low back pain is often accompanied by fear-avoidance cognitions, increased depressive symptoms and decreased quality of life. OBJECTIVE: Is the relationship between fear-avoidance cognitions and quality of life mediated by depressive symptoms? METHODS: Mediation analyses were conducted to predict the long-term quality of life with depressive symptoms as mediator using longitudinal data from 131 patients. RESULTS: Fear-avoidance cognitions prior to rehabilitation predicted the physical quality of life 24 months after rehabilitation, which was mediated by the degree of depressive symptoms 6 months after rehabilitation. The other assumed models could not be tested due to non-significant correlations between the model variables. CONCLUSION: To improve the physical quality of life, depressive symptoms should be included into the treatment of chronic low back pain.