de C Williams Amanda C, Richardson Phil H
INPUT Pain Management Unit, Riddell House, St. Thomas Hospital, London SE1 7EH UK United Medical and Dental Schools, St. Thomas Hospital, London SE1 7EH UK.
Pain. 1993 Nov;55(2):259-266. doi: 10.1016/0304-3959(93)90155-I.
The Beck Depression Inventory (BDI) has been widely used to document the prevalence of depressive symptomatology in samples of chronic pain patients and as an outcome measure in studies of the psychological management of chronic pain. Several BDI items have a somatic content (sleep disturbance, fatigue, etc). Since chronic pain may have similar somatic effects, the significance of the total BDI score in this population is unclear. Two hundred and forty mixed chronic pain patients completed the BDI at screening interview for a psychologically based pain management programme; of these, 207 (mean age 50.1 years; 63% female) were later admitted to the programme when the BDI was readministered along with measures of pain, anxiety, pain-related cognitions, and physical performance. The mean BDI score of the sample was 18.1, with 71.7% meeting criteria (scoring 13 or more) for at least mild depression. A principal-components analysis of the BDI yielded 3 meaningful factors labelled: sadness about health, self-reproach, and somatic disturbance. Among the most frequently endorsed items were those loading on the somatic factor. The pattern of relationships between individual factor scores and measures of pain, mood, cognition, and physical functioning indicated that the use of the total BDI score may give a misleading impression of the nature and degree of affective disturbance in this group of patients. The implications of these findings for our understanding of BDI scores obtained by chronic pain patients are discussed.
贝克抑郁量表（BDI）已被广泛用于记录慢性疼痛患者样本中抑郁症状的患病率，并作为慢性疼痛心理治疗研究中的一项结果指标。BDI的几个项目包含躯体内容（睡眠障碍、疲劳等）。由于慢性疼痛可能有类似的躯体影响，因此该人群中BDI总分的意义尚不清楚。240名混合型慢性疼痛患者在参加一项基于心理的疼痛管理项目的筛查访谈时完成了BDI测试；其中，207人（平均年龄50.1岁；63%为女性）后来在重新进行BDI测试以及疼痛、焦虑、疼痛相关认知和身体机能测量时被纳入该项目。样本的BDI平均得分为18.1，71.7%的人符合至少轻度抑郁的标准（得分13分或更高）。对BDI进行主成分分析得出了3个有意义的因素，分别标记为：对健康的悲伤、自责和躯体障碍。最常被认可的项目中，有一些属于躯体因素。个体因素得分与疼痛、情绪、认知和身体功能测量之间的关系模式表明，使用BDI总分可能会对该组患者情感障碍的性质和程度产生误导性印象。本文讨论了这些发现对我们理解慢性疼痛患者获得的BDI分数的意义。
