Psychological and functional predictors of chronic pain outcomes in youth with Duchenne muscular dystrophy

This prospective study identifies psychological distress and reduced physical function as independent contributors to chronic pain outcomes in DMD, with psychological distress mediating the effects of fatigue and HRQoL. Physical function was primarily associated with pain severity, whereas psychological distress and fatigue predicted the broader pain burden, including functional interference. These findings support a biopsychosocial model in which psychosocial factors translate underlying biological vulnerability into clinically significant pain.