Dm. Novy et al., GENDER DIFFERENCES IN THE EXPRESSION OF DEPRESSIVE SYMPTOMS AMONG CHRONIC PAIN PATIENTS, The Clinical journal of pain, 12(1), 1996, pp. 23-29
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.