title: Assessing depression in patients with chronic pain: a comparison of three rating scales.
abstract: BACKGROUND
  Considerable evidence has suggested depression is significantly more prevalent in patients with chronic pain. A number of studies exclusively based on Western samples have evaluated the effectiveness of depression rating scales in assessing depression in the chronic pain context. The objective of this cross-sectional study was to compare within a Chinese chronic pain sample three depression rating scales commonly used in identifying depression.
  
  
  METHODS
  A total of 366 Chinese patients with chronic pain attending either an orthopedic specialist clinic (n=185) or a multidisciplinary pain clinic (n=181) in Hong Kong completed a structured interview using CIS-R and two depression rating scales, the Beck Depression Inventory (BDI standard and short form) and the Center for Epidemiological Studies-Depression (CES-D). Patient scores on the BDI and CES-D were then assessed against their responses on the CIS-R to determine their effectiveness.
  
  
  RESULTS
  The prevalence of depression was 20.2% and 57.8% in the Orthopedics and Pain Clinic sample respectively. Results of ROC analyses showed that all the three measures performed well at predicting depression with AUC ≥ 0.89 and high sensitivity and specificity.
  
  
  CONCLUSIONS
  Our findings suggest that the three depression measures assessed have good predictive validity in the Chinese chronic pain context, and they could be used as screening or diagnostic measures of depression in Chinese chronic pain patients. The decision of using a specific measure and a specific cutoff score should be based on study aim and setting.
authors.affiliation: Department of Psychological Studies, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, Hong Kong. wingwong@ied.edu.hk
authors.forename: W S
authors.initials: WS
authors.lastname: Wong
authors.forename: P P
authors.initials: PP
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Yap
authors.forename: K H
authors.initials: KH
authors.lastname: Mak
authors.forename: B K H
authors.initials: BK
authors.lastname: Tam
authors.forename: R
authors.initials: R
authors.lastname: Fielding
mesh_terms: D000328:Adult; D044466:Asian People / Q000523:psychology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D003866:Depressive Disorder / Q000175:diagnosis; D016021:Epidemiologic Studies; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders; D014894:Weights and Measures