Self-report of depressive symptoms in low back pain patients

Crisson, James E.; Keefe, Francis J.; Wilkins, Robert H.; Cook, Wesley A.; Muhlbaier, Lawrence H.

doi:10.1002/1097-4679(198605)42:3<425::aid-jclp2270420304>3.0.co;2-a

Cited by 16 publications

(6 citation statements)

References 12 publications

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“…Because the diagnostic criteria for MDD include several somatic symptoms that can also be attributed to chronic pain (e.g., sleep disturbance, motor retardation, loss of energy, and change in appetite and weight), diagnosing depression in this population is not always straightforward. For instance, Crisson, Keefe, Wilkins, Cook, and Muhlbaier (1986) found that low back pain patients presented for neurosurgical evaluation were significantly more likely to report somatic rather than cognitive symptoms of depression, as measured by the Beck Depression Inventory (Beck, 1978), regardless of the degree of tissue pathology. Some assessment instruments have been designed to minimize or eliminate the somatic symptoms in an effort to avoid confounding the two sets of symptoms (e.g., Hospital Anxiety and Depression Scale; Zigmond & Snaith, 1983).…”

Section: Prevalence Of Depression Among Chronic Pain Patientsmentioning

confidence: 99%

Explaining high rates of depression in chronic pain: A diathesis-stress framework.

Banks¹,

Kerns²

1996

Psychological Bulletin

651

390

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Depression has been observed to accompany chronic pain. Yet, controversy remains regarding the extent and nature of the relationship between these 2 disorders. The authors analyze the literature regarding depression rates in chronic pain and other chronic medical populations and argue that depression appears to be highest among chronic pain patients. Drawing from cognitive-behavioral models of depression, the authors explore the unique psychological experiences of living with chronic pain that may account for the high prevalence of depression. Then a diathesis-stress framework is proposed to conceptualize the development of depression in chronic pain. Clinical and heuristic implications are discussed.

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Section: Prevalence Of Depression Among Chronic Pain Patientsmentioning

confidence: 99%

Explaining high rates of depression in chronic pain: A diathesis-stress framework.

Banks¹,

Kerns²

1996

Psychological Bulletin

651

390

View full text Add to dashboard Cite

show abstract

“…The scale has well-established psychometric properties 20 and has been used to assess depression among patients with chronic non-malignant pain. 21 Clinical cut-off scores on the BDI have been established as follows: 0 to 9-none or minimal depression; 10 to 18-mild to moderate depression; 19 to 29-moderate to severe depression;…”

Section: Assessmentmentioning

confidence: 99%

Psychological Correlates of Opioid Use in Patients with Chronic Nonmalignant Pain

Ciccone

Just²,

Bandilla³

et al. 2000

Journal of Pain and Symptom Management

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There is still controversy surrounding the use of opioid medication for patients with chronic nonmalignant pain. Schofferman has argued that long-term opioid use leads to a "downhill spiral" associated with loss of functional capacity and a corresponding increase in depressed mood. The present study was a retrospective comparison of opioid users vs. non-users to determine whether: (a) users have higher levels of disability, medical visitation, depression, and pain; (b) the behavioral problems associated with opioid use persist after controlling for the influence of other medication; (c) opioid use is in fact a predictor of illness behavior; and (d) higher levels of opioid consumption are associated with higher levels of disability and depression. A consecutive series of 243 patients with nonmalignant pain about to enroll at a tertiary clinic were retrospectively assigned to either an Opioid User (n = 87) or Non-User (n = 156) group. Compared to Non-Users, Opioid Users were more likely to be physically disabled ( P <0.05) and depressed ( P<0.05), as well as more likely to report pain at higher levels (P<0.001) and in more locations ( P<0.05). Despite the appearance of a downhill spiral, we were unable to demonstrate an association between opioid use and any measure of illness behavior after controlling for benzodiazepine use (with the possible exception of domestic disability). Instead, we found that benzodiazepine use was significantly associated with activity level ( P<0.05), medical visitation ( P<0.01), domestic disability ( P<0.01), depression ( P <0.01), and to a lesser degree, disability days (P<0.1). Using somatization as a reference variable, we found that opioid use failed to explain a comparable amount of variance in illness behavior. Finally, there was no evidence that higher levels of opioid use were associated with higher levels of disability or depression.

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“…As Cavannaugh et al (1983) have pointed out, the BDI also contains several items that are indicative of somatic complaints. Crisson et al (1986) found that chronic back pain patients endorsed significantly fewer cognitiveaffective than somatic items. According to Atkinson et al (1988), symptoms only have diagnostic significance if they are not attributable to the physical origin of the pain.…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the diagnosis of depression should be based only on symptoms not ascribed to physical disorders. Crisson et al (1986) found that chronic back pain patients endorsed significantly fewer cognitiveaffective than somatic items. Further studies confirmed the confounding effects of somatic items in the diagnosis of depression (Love, 1987;LaVonne Wesley et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Does dysphoric mood really predict the outcome of lumbar surgery? Methodological pitfalls in psychological research

Basler

Zimmer

1997

European Journal of Pain

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This study investigates the relationship between depression and continuous pain after lumbar surgery by means of the Beck Depression Inventory (BDI). To assess the possibility that some somatic symptoms are confounded with pain, the items of the inventory were divided into a cognitive-affective and somatic subscale. Data analysis is based on two assumptions: (1) continuous pain after surgery is more closely related to the somatic subscale than to the cognitive-affective subscale of the BDI; and (2) postsurgical pain can be better predicted by the somatic than by the cognitive-affective subscale presurgery. The sample consisted of 61 patients with lumbar nucleotomy and 107 patients with lumbar spondylodesis. Treatment outcome was evaluated 6 months after surgery in the nucleotomy patients and 9 months after surgery in the spondylodesis patients. At follow-up, subjects conducted a pain diary over a period of 2 weeks. Correlational methodology was applied. Data analysis of both samples confirms the first assumption, whereas the second assumption is only partly confirmed. Only in the spondylodesis sample was pain intensity at follow-up predicted by the total BDI score. Regarding the subscales, the cognitive-affective scale, but not the somatic scale, was related to surgical outcome in this sample. The relationship between presurgical depression and pain at follow-up failed to reach statistical significance in the nucleotomy sample. It is concluded that lack of awareness of the confounding effects of somatic items in questionnaires for the assessment of mood may contribute to erroneous conclusions drawn from studies reported in the literature.

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Self-report of depressive symptoms in low back pain patients

Cited by 16 publications

References 12 publications

Explaining high rates of depression in chronic pain: A diathesis-stress framework.

Explaining high rates of depression in chronic pain: A diathesis-stress framework.

Psychological Correlates of Opioid Use in Patients with Chronic Nonmalignant Pain

Does dysphoric mood really predict the outcome of lumbar surgery? Methodological pitfalls in psychological research

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