Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy.
Fondazione ISAL, Institute for Research on Pain, Torre Pedrera, Italy.
Pain Manag Nurs. 2022 Apr;23(2):158-167. doi: 10.1016/j.pmn.2021.03.009. Epub 2021 May 5.
This narrative review sought to explore the main critical issues in the assessment of depression in chronic pain and to identify self-report tools that can be reliably used for measuring it.
Narrative review of the literature.
Articles were obtained through a search of three databases and a hand search of the references of full-text papers. Key results within the retrieved articles were summarized and integrated to address the review objectives.
Criterion contamination, different ways to define and evaluate pain and depression across studies, variability in chronic pain samples and settings, pitfalls of diagnostic systems and self-reports, and reluctance to address (or difficulty of recognizing) depression in patients and healthcare providers emerged as main critical issues. The Beck Depression Inventory seems to be the more accurate tool to evaluate depression in chronic pain patients, while other instruments such as the Patient Health Questionnaire could be recommended for a rapid screening.
Assessment of depression comorbidity in chronic pain represents a challenge in both research and clinical practice; the choice and use of tests, as well as the score interpretation, require clinical reasoning.
Nurses play an important role in screening for depression. Cognitive contents of depression should be carefully evaluated since somatic symptoms may be confusing in the chronic pain context. Some self-reports may be useful for rapid screening. It is also advisable to consider other relevant patient information in evaluating depression.
本叙述性评论旨在探讨慢性疼痛患者抑郁评估中的主要关键问题，并确定可用于可靠测量抑郁的自评工具。
文献的叙述性评论。
通过对三个数据库的检索和全文论文参考文献的手工检索获得了文章。总结并整合了检索文章中的关键结果，以解决综述目的。
标准污染、研究间定义和评估疼痛和抑郁的不同方式、慢性疼痛样本和环境的变异性、诊断系统和自评的陷阱以及患者和医疗保健提供者不愿或难以识别抑郁，这些都成为主要的关键问题。贝克抑郁量表似乎是评估慢性疼痛患者抑郁的更准确工具，而其他工具，如患者健康问卷，可用于快速筛查。
在研究和临床实践中，慢性疼痛患者共病抑郁的评估都是一个挑战；测试的选择和使用以及评分解释都需要临床推理。
护士在抑郁筛查中起着重要作用。由于在慢性疼痛环境下躯体症状可能令人困惑，因此应仔细评估抑郁的认知内容。一些自评可能有助于快速筛查。在评估抑郁时，还应考虑其他相关患者信息。
