Diagnosing Depression in Chronic Pain Patients: DSM-IV Major Depressive Disorder vs. Beck Depression Inventory (BDI)

Abstract

BackgroundDiagnosing depression in chronic pain is challenging due to overlapping somatic symptoms. In questionnaires, such as the Beck Depression Inventory (BDI), responses may be influenced more by pain than by the severity of depression. In addition, previous studies have suggested that symptoms of negative self-image, a key element in depression, are uncommon in chronic pain-related depression. The object of this study is to assess the relationship of the somatic and cognitive-emotional items of BDI with the diagnosis of depression, pain intensity, and disability.MethodsOne hundred consecutive chronic pain patients completed the Structured Clinical Interview for DSM Disorders (SCID) for the diagnosis of major depressive disorder (MDD) according to DSM-IV. Two subscales of BDI (negative view of self and somatic-physical function) were created according to the factor model presented by Morley.ResultsIn the regression analysis, the somatic-physical function factor associated with MDD, while the negative view of self factor did not. Patients with MDD had higher scores in several of the BDI items when analysed separately. Insomnia and weight loss were not dependent on the depression diagnosis.LimitationsThe relatively small sample size and the selected patient sample limit the generalisability of the results.ConclusionsSomatic symptoms of depression are also common in chronic pain and should not be excluded when diagnosing depression in pain patients. Regardless of the assessment method, diagnosing depression in chronic pain remains a challenge and requires careful interpretation of symptoms.

Development and psychometric testing the Health of Body, Mind and Spirit Scale for assessing individuals who have drug abuse histories

“…However, the following five items were removed: “I cannot concentrate,” “I feel alone or lonely,” “I feel anxiety for no reason,” “I am easily irritated,” and “My work is not a stable job.” Some questions were removed because they overlapped with the other questions. For example, “feeling alone” overlapped with “I feel as though nobody cares about me.” Additionally, “I feel anxiety without any reason” overlapped with “I feel depressed.” The majority of the participants (87.1%) in this study were employed, which might have contradicted “My work is not a stable job.” People who are depressed often have the inability to concentrate or are irritated (Knaster et al., ). Therefore, the deleted items “I cannot concentrate” and “I am easily irritated” might have overlapped with “I feel depressed.”…”

“…The majority of the participants (87.1%) in this study were employed, which might have contradicted "My work is not a stable job." People who are depressed often have the inability to concentrate or are irritated (Knaster et al, 2016). Therefore, the deleted items "I cannot concentrate" and "I am easily irritated" might have overlapped with "I feel depressed.…”

Quality of life in men with chronic scrotal pain

“…Perhaps men presenting with pain scores ≥ 7 may benefit from further depression screening with validated scales such as the Beck Depression Inventory, which may provide opportunity for further psychiatric evaluation/intervention where it may not have been previously considered. 19 Men with CSP frequently suffer from limitations in ability to work, social activities, and sexual functioning, any and all of which could contribute to lower QoL and depressive symptoms.…”

Unsupervised Classifications of Depression Levels Based on Machine Learning Algorithms Perform Well as Compared to Traditional Norm-Based Classifications

“…Moreover, such methods are simply too costly and laborintensive for large-scale screening for depression (9,10). Consequently, it is out of necessity to use self-report surveys or scales as large-scale screening measures (11,12). The commonly used scales include Beck Depression Inventory [BDI, (13)], Center for Epidemiologic Studies-Depression [CESD, (14)], and Symptom Checklist 90-Revision [SCL-90-R, (15)].…”

“…Researchers have also determined different cutoff points (norms) for various categories of depression. For example, for BDI-13, the score ranges for various levels of depression are 0-4 (No Depression), 5-7 (Mild), [8][9][10][11][12][13][14][15], and . These cutoff points were based on the original study of Beck et al (13).…”