The short form of the Beck Depression Inventory: validity issues with chronic pain patients.

OBJECTIVE: To investigate the validity of the Beck Depression Inventory short form when used to screen for depression in chronic pain patients.
SETTING: A multidisciplinary pain management center located in a major university medical center. PATIENTS: Seven hundred sixty-five persons presenting for evaluation of chronic pain, including low back pain, head/neck pain, and extremity pain. MEASURES: Beck Depression Inventory short form, McGill Pain Questionnaire, Pain Disability Index, pain drawing, and Quality of Life Scale. RESULTS AND
CONCLUSIONS: Items on the Beck Depression Inventory short form reflecting pain-related interference with function (i.e., disability) were endorsed to a greater degree than affective and cognitive items. A factor analysis of the inventory yielded two affective/cognitive factors and one "disability" factor (work inhibition and fatigue). The correlations between the factor scores and the Pain Disability Index suggested that endorsement of the work inhibition and fatigue items by chronic pain patients may not be indicative of affective disturbance. The results suggest that these items should be evaluated critically for their contribution to the total score of the Beck Depression Inventory short form when assessing depression in chronic pain patients.