THE SHORT-FORM OF THE BECK DEPRESSION INVENTORY - VALIDITY ISSUES WITH CHRONIC PAIN PATIENTS

Objective: To investigate the validity of the Beck Depression Inventor y short form when used to screen for depression in chronic pain patien ts. Setting: A multidisciplinary pain management center located in a m ajor university medical center. Patients: Seven hundred sixty-five per sons presenting for evaluation of chronic pain, including low back pai n, head/neck pain, and extremity pain. Measures: Beck Depression Inven tory short form, McGill Pain Questionnaire, Pain Disability Index, pai n drawing, and Quality of Life Scale. Results and Conclusions: Items o n the Beck Depression Inventory short form reflecting pain-related int erference with function (i.e., disability) were endorsed to a greater degree than affective and cognitive items. A factor analysis of the in ventory yielded two affective/cognitive factors and one ''disability'' factor (work inhibition and fatigue). The correlations between the fa ctor scores and the Pain Disability Index suggested that endorsement o f the work inhibition and fatigue items by chronic pain patients may n ot be indicative of affective disturbance. The results suggest that th ese items should be evaluated critically for their contribution to the total score of the Beck Depression Inventory short form when assessin g depression in chronic pain patients.