GENDER DIFFERENCES IN THE EXPRESSION OF DEPRESSIVE SYMPTOMS AMONG CHRONIC PAIN PATIENTS

Objective: To investigate the extent to which gender differences in th e expression of depressive symptomatology exist among chronic pain pat ients. Setting: A multidisciplinary pain center affiliated with a stat e medical school in the southern United States. Patients: A total gene ral sample of 245 patients with heterogeneous chronic pain complaints randomly selected from a database of similar to 1,000 pretreatment eva luation patient files. A depressed subsample of 113 patients based on scores greater than or equal to 15 on the Beck Depression Inventory (B DI). Measure: The 21-item BDI. Results and Conclusions: Gender differe nces in total BDI scores were not revealed for the total general sampl e or depressed subsample, but gender differences in the expression of depressive symptoms (i.e., item level responses) were found via separa te discriminant function analyses on the total general sample and depr essed subsample. Consistent with previous studies performed on diverse samples, females' higher endorsement of body image distortion was not ed in both of our samples. Females also endorsed significantly higher levels of fatigue in our total sample. Items that were not significant in our total sample include females' higher levels of loss of appetit e and crying. In the depressed subsample, items probing pessimism and failure were not statistically significantly different to males' endor sing higher levels of each. Sensitivity to these gender differences is suggested in clinical practice. The likely consequences that these di fferences in the experience and expression of distress have on coping activities (e.g., help-seeking responses) and the reactions of others (e.g., health-care providers) are highlighted.