ASSESSING DEPRESSION AMONG PERSONS WITH CHRONIC PAIN USING THE CENTERFOR EPIDEMIOLOGIC STUDIES DEPRESSION SCALE AND THE BECK DEPRESSION INVENTORY - A COMPARATIVE-ANALYSIS

Objective: This study examined the ability of two self-report question naires, the Beck Depression Inventory (BDI) and the Center for Epidemi ological Studies-Depression Scale (CES-D), to discriminate between chr onic pain patients with and without major depression. Since previous r esearch has suggested that medical conditions such as chronic pain can influence the endorsement of items that measure neurovegetative sympt oms of depression, the accuracy of each of these questionnaires was al so assessed eliminating these items. Subjects: These included 132 cons ecutive patients with chronic pain, 44 of whom were diagnosed as suffe ring from major depression according to DSM-IV criteria. Methods: Pati ents were administered a battery of questionnaires that included the C ES-D and BDI. They were also interviewed by a clinical psychologist to determine the presence or absence of major depression. Results: Both questionnaires were able to discriminate significantly between persons with and without major depression. Removal of the somatic items on ea ch questionnaire did not improve their accuracy. Discriminant function analysis revealed an optimal cut-off score of 21 for the BDI, and 27 for the CES-D. Overall hit rates at these cut-offs for the two questio nnaires were comparable, while the CES-D had somewhat better sensitivi ty (81.8% vs. 68.2%). Conversely, the BDI had slightly better specific ity (78.4% vs. 72.7%). Conclusion: The results suggest that both quest ionnaires have good predictive validity among chronic pain patients, a nd decisions regarding the use of one questionnaire rather than the ot her may depend upon the goals of the user and the setting within which the questionnaire is used.