PMID- 8714800
OWN - NLM
STAT- MEDLINE
DCOM- 19960926
LR  - 20190914
IS  - 0163-8343 (Print)
IS  - 0163-8343 (Linking)
VI  - 17
IP  - 6
DP  - 1995 Nov
TI  - The reliability of depression diagnosis in chronic low back pain. A pilot study.
PG  - 399-413
AB  - The variability in estimated rates of major depressive disorder (MDD) in chronic 
      pain samples may be accounted for by sample and methodological differences. Most 
      studies rely on a single measure of depression and lack independent or repeated 
      measures. This study investigated the prevalence of psychiatric disorders in a 
      convenience sample of 18 patients disabled by low back pain (LBP) referred to, 
      evaluated, and treated in a comprehensive pain rehabilitation program 
      specifically designed to restore work readiness and return to work. Subjects had 
      one or more spinal conditions, had work-related back pain for more than 6 months 
      (x = 23.8), were Caucasian, predominantly young (x = 37.5) and male (55%), and 
      were disabled on workers' compensation and approved for rehabilitation. The 
      performance of three diagnostic procedures, the Pain Medicine Evaluation, an 
      independent Structured Clinical Interview for DSM-III-R (SCID), and Longitudinal 
      Clinical Diagnosis were compared with the "gold standard" of the Final Diagnosis 
      which incorporated information from the other three. Also, the performance of a 
      questionnaire, The Pain & Mood Structural Interview (PMSI), designed to assess 
      the causal relationship of pain and mood and specifically the confounding effects 
      of physical factors, was examined. Thirteen of 18 patients (72%) were diagnosed 
      with MDD at Final Diagnosis. MDD diagnosis was made on 4 of 18 patients (22%) on 
      the initial Pain Medicine Evaluation and on 9 of 18 patients (50%) on the SCID, 
      with only 1 ruled out by the confounding questionnaire, for a SCID current 
      prevalence of 44%. Both the SCID and Pain Medicine Evaluation accurately 
      diagnosed the MDD cases they identified; 9 of 13 MDD cases (69%) were 
      precipitated by a physical factor other than their pain. Three episodes of MDD 
      were ruled out by confounding. These findings are discussed in relation to their 
      implications for assessing pain patients for psychiatric comorbidity.
FAU - Gallagher, R M
AU  - Gallagher RM
AD  - Comprehensive Pain and Rehabilitation Center, SUNY at Stony Brook, NY 11794-8101, 
      USA.
FAU - Moore, P
AU  - Moore P
FAU - Chernoff, I
AU  - Chernoff I
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Gen Hosp Psychiatry
JT  - General hospital psychiatry
JID - 7905527
SB  - IM
MH  - Adult
MH  - Combined Modality Therapy
MH  - Depressive Disorder/*diagnosis/psychology/rehabilitation
MH  - Female
MH  - Humans
MH  - Low Back Pain/*psychology/rehabilitation
MH  - Male
MH  - Occupational Diseases/*psychology/rehabilitation
MH  - Pain Measurement
MH  - Patient Care Team
MH  - Personality Assessment
MH  - Psychophysiologic Disorders/*psychology/rehabilitation
MH  - Rehabilitation, Vocational/psychology
MH  - Workers' Compensation
EDAT- 1995/11/01 00:00
MHDA- 1995/11/01 00:01
CRDT- 1995/11/01 00:00
PHST- 1995/11/01 00:00 [pubmed]
PHST- 1995/11/01 00:01 [medline]
PHST- 1995/11/01 00:00 [entrez]
AID - 0163834395000887 [pii]
AID - 10.1016/0163-8343(95)00088-7 [doi]
PST - ppublish
SO  - Gen Hosp Psychiatry. 1995 Nov;17(6):399-413. doi: 10.1016/0163-8343(95)00088-7.