title: Dysphoria: a major symptom factor in persons with disability or chronic illness.
abstract: Depression frequently is diagnosed in persons with chronic illness or following the onset of disability. The overlap of symptoms of many chronic illnesses and disabling conditions with depression may lead to an overestimation of depression in such populations. Some investigators have proposed revised criteria for diagnosing depression in these conditions without an understanding of the contribution of diagnostic criteria in disabling conditions. This study investigated the nature of depressive symptom criteria constellations by individually factor analyzing the Inventory to Diagnose Depression (based on DSM-III diagnostic criteria) in spinal cord injury (n = 134), rheumatoid arthritis (n = 78), student (n = 140), and community (n = 150) groups. A four-factor solution emerged, with the first factor labeled "dysphoria" being represented by symptoms of negative self-evaluations, depressed affect, and suicidal ideation. The results indicate that a core element of the syndrome of depression is dysphoria, which suggests that the contribution of somatic items may be less important to the identification of the depressive syndrome in chronic illness.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Missouri-Columbia School of Medicine.
authors.forename: R G
authors.initials: RG
authors.lastname: Frank
authors.forename: J M
authors.initials: JM
authors.lastname: Chaney
authors.forename: D L
authors.initials: DL
authors.lastname: Clay
authors.forename: M S
authors.initials: MS
authors.lastname: Shutty
authors.forename: N C
authors.initials: NC
authors.lastname: Beck
authors.forename: D R
authors.initials: DR
authors.lastname: Kay
authors.forename: T R
authors.initials: TR
authors.lastname: Elliott
authors.forename: S
authors.initials: S
authors.lastname: Grambling
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation; D002908:Chronic Disease / Q000523:psychology* / Q000534:rehabilitation; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D006233:Persons with Disabilities / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012046:Rehabilitation / Q000523:psychology*; D012047:Rehabilitation Centers; D012803:Sick Role; D013119:Spinal Cord Injuries / Q000523:psychology / Q000534:rehabilitation