Objective: Previous studies of pain behavior in patients with chronic
pain have shown that depressed patients exhibit more pain behavior tha
n nondepressed patients. This study sought to extend these findings an
d to examine the possible causes of the observed differences. Design:
Patients completed the short form of the Beck Depression Inventory, an
d their pain behavior was simultaneously rated by themselves and train
ed observers. Patients: Subjects were 37 inpatients in a chronic pain
program. Results: Both depressed and nondepressed subjects rated thems
elves as exhibiting more pain behavior than did nurse ratings. While n
urses rated pain behaviors as similar among the depressed and the nond
epressed groups, patient ratings indicated significantly more pain beh
avior among depressed than nondepressed patients. Conclusions: These r
esults suggest that cognitive factors may influence self-ratings of pa
in behavior by depressed subjects.